踝关节定量CT诊断骨质疏松症的价值

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Application value of quantitative CT in diagnosis of osteoporosis at the ankle joint

ZHU Mingl，KANG Jingxia²，HAN Guang'，LI Qiangl，LIU Xiaopengl

'DepartmentofMedicalImaging，inyiTrditionalhineseMedicineHospital，inyi76oo，hina；Departmentofedical Imaging，Linyi People'sHospital，Linyi276ooo，China.

[Abstract]Objective：ToexploretheapplicationvalueofquantitativeCT（QCT）oftheanklejointinthediagnosisof osteoporosis.Methods：Aretrospectiveanalysiswasconstructedon109patientswhounderwentconcurrent lumbarspine andanklejointCTscans.Thebonemineraldensity（BMD）ofthedistaltibia，talus，calcaneusandanklejointwasmeasured. Pearsoncorelationanalysiswasusedtoinvestigatethecorelationbetweenage，BMDofvariousmeasuredregionsoftheankle joint，and lumbar spineBMD.ROC curves were analyzed todetermine thecut-offvalues forBMD invarious measuredregions of theanklejointtopredictabnormalbonemassResults：Among the109 patients，61cases hadnormalBMD，29caseshad decreasedBMD，and19caseshadosteoporosis.TheBMDvaluesofdistaltibia，talus，calcaneus，anklejointandlumbarspine were（145.68±52.30），（271.13±61.89）， （102.10±45.52 ）， （173.31±48.30 ）and （127.73±49.40）mg/cm3 .TheBMDsof distal tibia，talus，calcaneusandanklejointshowedpositivecorelatonswithlumbarspineBMD，withthehighestcorrlationobserved between the ankle joint BMD and the lumbar spine BMD ⋅r=0.690，P<0.01 ）.While age showed negative correlations with BMDs in all measured regions，with the highest correlation observed with lumbar spine BMD（ ⋅=-0.725，P<0.01 ）. ROC curve analysisrevealedthattheanklejointBMDhadthebestdiagnosticpeformanceinpredictingabnormalbonemass，witha cut-off value of 182.6mg/cm3 and an AUC of 0.891（ P<0.05 ）.Conclusions：The ankle joint BMD measured by QCT is correlatedwith lumbarspineBMD，demonstratingsubstantialvalueinassessingabnormalbonemass.Theyprovideastrong alternative reference，especially when lumbar spine data are lacking.

[Key words] Tomography，X-ray computed;Bone mineral density;Lumbar spine;Ankle joint; Correlation

近年来，我国骨质疏松症和脆性骨折的发病率持续上升[1]，据统计在50岁以上人群中，骨质疏松症患病率女性约 29.1% ，男性约 6.5%[2] 。（剩余10132字）