| Objective: With the aging of the population,there are currently more than 90 million osteoporosis patients nationwide,and the number of osteoporosis is increasing year by year and the trend is younger,and more and more patients have fragility fractures,which is one of the important causes of death and disability.From the current stage of osteoporosis detection and research,the value of dual-energy X-ray absorptiometry(DXA)has been unanimously recognized as the "gold standard",but it is affected by severe degeneration of the spine,vertebral fractures and vascular calcification,resulting in inaccurate BMD test results.CT value measurement,as an emerging method for measuring bone mineral density,can avoid the former influencing factors and therefore improve the accuracy of osteoporosis diagnosis,and can be used as a new complementary method for DXA diagnosis of osteoporosis.In clinical applications,CT machines are more popular than dual-energy X-ray detectors for screening and diagnosis of osteoporosis for tertiary prevention,thereby reducing disability,mortality and the economic burden on the country.At the same time,by being able to measure the CT values of individual vertebrae based on the patient’s already performed CT examination of the thoracic or lumbar spine,the clinical surgeon can more accurately determine whether osteoporosis is present in the vertebrae being evaluated to select a better surgical plan and avoid further complications.Methods : In a retrospective study,a total of 160 patients who were simultaneously examined by CT of the chest,CT of the lumbar spine and DXA in our hospital were collected and grouped according to gender and different age groups,including 60 males and 100 females.The axial CT measurements of the CT values of each thoracic and lumbar(L1～L4)vertebral cancellous bone were measured,and the mean value of the CT measurements of each thoracic and lumbar(L1～L4)vertebral cancellous bone was calculated and recorded.The values of T value of each vertebral body of the lumbar spine(L1～L4)and the average bone density value of the vertebral body(L1～L4)examined by dual-energy X-ray were also recorded.The intra-group correlation and difference analysis was performed by SPSS 22.0 statistical software,and the CT values of each vertebra of the lumbar spine(L1～L4)and the mean CT values of the lumbar spine(L1～L4)were correlated with the L1～L4 T-values and the mean T-values of the dual-energy X-ray findings,respectively.At the same time,differential analysis of CT values between the thoracic and lumbar spine,and between the upper thoracic spine(1～6 vertebrae)and the lower thoracic spine(7～12 vertebrae)was performed.Results: The CT values of each vertebra of the lumbar spine(L1～L4)and the mean CT values of the lumbar spine(L1～L4)within each group corresponded to the L1～L4 T values of the dual-energy X-ray findings and the mean T values of the Pearson correlation coefficient r values in the range of 0.719 to 0.940,P <0.05,respectively.Analysis of the differences in CT values between the thoracic and lumbar spine,upper thoracic spine(1～6 vertebrae)and lower thoracic spine(7～12 vertebrae)was performed and showed that the significant two-tailed P value was less than 0.05 in all groups except for the group older than 75 years,and the statistical differences between the thoracic and lumbar spine,upper thoracic spine and lower thoracic spine were statistically significant.Conclusions: CT value testing is closely related to DXA and has a high diagnostic value for osteoporosis,which can be used as an effective supplement and evaluation modality for the diagnosis of osteoporosis.Before the age of 75,the bone density of the thoracic spine was higher than that of the lumbar spine,and the bone density of the upper thoracic spine was higher than that of the lower thoracic spine;after the age of 75,there was no significant difference in bone density between the cancellous bone of the thoracic and lumbar spine. |
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