ISSN 1004-4140
CN 11-3017/P
王盟盟, 张磊, 周凤云, 等. 双层光谱CT、QCT及DXA在骨质疏松诊断中的精确性与效能比较[J]. CT理论与应用研究（中英文）, 2024, 33(6): 717-724. DOI: 10.15953/j.ctta.2024.086.
引用本文: 王盟盟, 张磊, 周凤云, 等. 双层光谱CT、QCT及DXA在骨质疏松诊断中的精确性与效能比较[J]. CT理论与应用研究（中英文）, 2024, 33(6): 717-724. DOI: 10.15953/j.ctta.2024.086.
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WANG M M, ZHANG L, ZHOU F Y, et al. Comparative Study of the Accuracies and Efficiencies of Dual-layer Spectral CT, QCT, and DXA for Osteoporosis Diagnosis[J]. CT Theory and Applications, 2024, 33(6): 717-724. DOI: 10.15953/j.ctta.2024.086. (in Chinese).
Citation: WANG M M, ZHANG L, ZHOU F Y, et al. Comparative Study of the Accuracies and Efficiencies of Dual-layer Spectral CT, QCT, and DXA for Osteoporosis Diagnosis[J]. CT Theory and Applications, 2024, 33(6): 717-724. DOI: 10.15953/j.ctta.2024.086. (in Chinese).
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双层光谱CT、QCT及DXA在骨质疏松诊断中的精确性与效能比较

Comparative Study of the Accuracies and Efficiencies of Dual-layer Spectral CT, QCT, and DXA for Osteoporosis Diagnosis

    摘要
  • 摘要: 目的：本研究旨在比较双层光谱CT、QCT和DXA在骨质疏松症诊断中的精确性与效能。方法：回顾性收集2023年1月至2023年10月北京积水潭医院脊柱外科门诊患者30例（男15例，年龄（56.6±8.31）岁；女性15例，（65.13±7.16）岁）。所有患者均接受过腰椎双层光谱CT扫描（包括QCT）以及DXA扫描。测量纳入所有患者的L1-L3椎体体积骨密度值和基于DXA扫描的面积骨密度值；依据腰椎QCT和DXA诊断骨质疏松症的标准将研究对象分为骨量正常组、骨量异常组（低骨量组和骨质疏松组）；使用Fisher确切概率法对双层光谱CT、QCT和DXA测量的骨密度诊断骨质疏松的准确率进行比较以及使用ROC曲线计算双层光谱CT测量的体积骨密度值诊断骨质疏松的敏感度和特异性。结果：3种方法测量的L1-L3平均骨密度值之间都有极好的相关性（0.751～0.971）；双层光谱CT、QCT以及DXA诊断骨质疏松的准确率在男性中分别为66.7％（10/15）、53.3％（8/15）和40％（6/15）；在女性中分别为93.3％（14/15）、86.7％（13/15）和60％（9/15），差异有统计学意义。双层光谱CT分别以QCT和DXA为参考标准诊断骨质疏松的曲线下面积分别0.995（灵敏度88.9％；特异度90.5％）和0.784（灵敏度60％；特异度93.3％）。结论：基于双层光谱CT测量的体积骨密度值在骨质疏松诊断中与QCT相当，其诊断效能优于DXA。

     

    Abstract: Objective: In this study, we aimed to compare the accuracies and efficiencies of dual-layer spectral computed tomography (CT), quantitative CT (QCT), and dual-energy X-ray absorptiometry (DXA) in diagnosing osteoporosis. Methods: From January to October, 2023, 30 outpatients, including 15 males (age (56.6±8.31) years old) and 15 females (age (65.13±7.16) years old), at the spine surgery department of Beijing Jishuitan Hospital were retrospectively analyzed. All patients underwent bilayer spectral CT, QCT, and DXA of the lumbar spine. Additionally, bone mineral density (BMD) values for the L1–3 vertebral bodies and areal BMD values were measured using DXA. Based on the diagnostic criteria for osteoporosis using lumbar spine QCT and DXA, the study participants were divided into three groups: normal bone mass, abnormal/low bone mass, and osteoporosis groups. Accuracies of dual-energy spectral CT, QCT, and DXA for BMD measurements to diagnose osteoporosis were compared using Fisher’s exact test. Moreover, sensitivity and specificity of dual-energy spectral CT to measure volumetric BMD values for osteoporosis diagnosis were calculated using receiver operating characteristic curves. Results: A strong correlation was observed among the average BMD values for L1–3 measured using all three methods (0.751～0.971). Accuracies of osteoporosis diagnosis using dual-energy spectral CT, QCT, and DXA were 66.7% (10/15), 53.3% (8/15), and 40% (6/15), respectively, in males and 93.3% (14/15), 86.7% (13/15), and 60% (9/15), respectively, in females, with statistically significant differences. Dual-energy spectral CT showed area under the curve values of 0.995 (sensitivity: 88.9%; specificity: 90.5%) and 0.784 (sensitivity: 60%; specificity: 93.3%) with QCT and DXA as reference standards, respectively, for osteoporosis diagnosis. Conclusion: Volumetric BMD values measured using dual-energy spectral CT were comparable to those measured using QCT for osteoporosis diagnosis, and both outperformed DXA in terms of diagnostic efficiency.

     

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