Congyang Xue, Guangda Sun, Nan Wang, Xiyu Liu, Gansheng He, Yubo Wei, Zhipeng Xi
{"title":"胸部计算机断层扫描测量的 Hounsfield 单位在评估胸椎胸腰段骨密度方面的价值。","authors":"Congyang Xue, Guangda Sun, Nan Wang, Xiyu Liu, Gansheng He, Yubo Wei, Zhipeng Xi","doi":"10.31616/asj.2023.0438","DOIUrl":null,"url":null,"abstract":"<p><strong>Study design: </strong>A retrospective study.</p><p><strong>Purpose: </strong>To investigate the correlation between Hounsfield unit (HU) values measured by chest computed tomography (CT) and dual-energy Xray absorptiometry (DXA) T-scores. HU-based thoracolumbar (T11 and T12) cutoff thresholds were calculated for a cohort of Chinese patients.</p><p><strong>Overview of literature: </strong>For patients with osteoporosis, the incidence of fractures in the thoracolumbar segment is significantly higher than that in other sites. However, most current clinical studies have focused on L1.</p><p><strong>Methods: </strong>This retrospective study analyzed patients who underwent chest CT and DXA at our hospital between August 2021 and August 2022. Thoracic thoracolumbar segment HU values, lumbar T-scores, and hip T-scores were computed for comparison, and thoracic thoracolumbar segment HU thresholds suggestive of potential bone density abnormalities were established using receiver operating characteristic curves.</p><p><strong>Results: </strong>In total, 470 patients (72.4% women; mean age, 65.5±12.3 years) were included in this study. DXA revealed that of the 470 patients, 90 (19%) had osteoporosis, 180 (38%) had reduced osteopenia, and 200 (43%) had normal bone mineral density (BMD). To differentiate osteoporosis from osteopenia, the HU threshold was established as 105.1 (sensitivity, 54.4%; specificity, 72.2%) for T11 and 85.7 (sensitivity, 69.4%; specificity, 61.1%) for T12. To differentiate between osteopenia and normal BMD, the HU threshold was 146.7 for T11 (sensitivity, 57.5%; specificity, 84.4%) and 135.7 for T12 (sensitivity, 59.5%; specificity, 80%).</p><p><strong>Conclusions: </strong>This study supports the significance of HU values from chest CT for BMD assessment. Chest CT provides a new method for clinical opportunistic screening of osteoporosis. When the T11 HU is >146.7 or the T12 HU is >135.7, additional osteoporosis testing is not needed unless a vertebral fracture is detected. If the T11 HU is <105.1 or the T12 HU is <85.7, further DXA testing is strongly advised. In addition, vertebral HU values that fall faster than those of the T11 and L1 vertebrae may explain the high incidence of T12 vertebral fractures.</p>","PeriodicalId":8555,"journal":{"name":"Asian Spine Journal","volume":null,"pages":null},"PeriodicalIF":2.3000,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11222884/pdf/","citationCount":"0","resultStr":"{\"title\":\"Value of Hounsfield units measured by chest computed tomography for assessing bone density in the thoracolumbar segment of the thoracic spine.\",\"authors\":\"Congyang Xue, Guangda Sun, Nan Wang, Xiyu Liu, Gansheng He, Yubo Wei, Zhipeng Xi\",\"doi\":\"10.31616/asj.2023.0438\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Study design: </strong>A retrospective study.</p><p><strong>Purpose: </strong>To investigate the correlation between Hounsfield unit (HU) values measured by chest computed tomography (CT) and dual-energy Xray absorptiometry (DXA) T-scores. HU-based thoracolumbar (T11 and T12) cutoff thresholds were calculated for a cohort of Chinese patients.</p><p><strong>Overview of literature: </strong>For patients with osteoporosis, the incidence of fractures in the thoracolumbar segment is significantly higher than that in other sites. However, most current clinical studies have focused on L1.</p><p><strong>Methods: </strong>This retrospective study analyzed patients who underwent chest CT and DXA at our hospital between August 2021 and August 2022. Thoracic thoracolumbar segment HU values, lumbar T-scores, and hip T-scores were computed for comparison, and thoracic thoracolumbar segment HU thresholds suggestive of potential bone density abnormalities were established using receiver operating characteristic curves.</p><p><strong>Results: </strong>In total, 470 patients (72.4% women; mean age, 65.5±12.3 years) were included in this study. DXA revealed that of the 470 patients, 90 (19%) had osteoporosis, 180 (38%) had reduced osteopenia, and 200 (43%) had normal bone mineral density (BMD). To differentiate osteoporosis from osteopenia, the HU threshold was established as 105.1 (sensitivity, 54.4%; specificity, 72.2%) for T11 and 85.7 (sensitivity, 69.4%; specificity, 61.1%) for T12. To differentiate between osteopenia and normal BMD, the HU threshold was 146.7 for T11 (sensitivity, 57.5%; specificity, 84.4%) and 135.7 for T12 (sensitivity, 59.5%; specificity, 80%).</p><p><strong>Conclusions: </strong>This study supports the significance of HU values from chest CT for BMD assessment. Chest CT provides a new method for clinical opportunistic screening of osteoporosis. When the T11 HU is >146.7 or the T12 HU is >135.7, additional osteoporosis testing is not needed unless a vertebral fracture is detected. If the T11 HU is <105.1 or the T12 HU is <85.7, further DXA testing is strongly advised. 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引用次数: 0
摘要
研究设计:目的:研究胸部计算机断层扫描(CT)测量的 Hounsfield 单位(HU)值与双能 X 射线吸收测量(DXA)T 评分之间的相关性。文献综述:对于骨质疏松症患者而言,胸腰段骨折的发生率明显高于其他部位。然而,目前大多数临床研究都集中在 L1 段:这项回顾性研究分析了 2021 年 8 月至 2022 年 8 月期间在我院接受胸部 CT 和 DXA 检查的患者。计算胸椎-胸腰段 HU 值、腰椎 T 值和髋关节 T 值以进行比较,并使用接收器操作特征曲线确定提示潜在骨密度异常的胸椎-胸腰段 HU 阈值:本研究共纳入 470 名患者(72.4% 为女性;平均年龄为 65.5±12.3 岁)。DXA 显示,在 470 名患者中,90 人(19%)患有骨质疏松症,180 人(38%)患有骨质疏松症,200 人(43%)的骨矿密度(BMD)正常。为区分骨质疏松症和骨质疏松症,T11 和 T12 的 HU 临界值分别为 105.1(灵敏度为 54.4%;特异度为 72.2%)和 85.7(灵敏度为 69.4%;特异度为 61.1%)。为区分骨质疏松症和正常 BMD,T11 的 HU 临界值为 146.7(灵敏度为 57.5%;特异度为 84.4%),T12 为 135.7(灵敏度为 59.5%;特异度为 80%):本研究证实了胸部 CT 的 HU 值对 BMD 评估的重要性。胸部 CT 为骨质疏松症的临床机会性筛查提供了一种新方法。当 T11 HU >146.7 或 T12 HU >135.7 时,除非发现脊椎骨折,否则无需进行额外的骨质疏松症检测。如果 T11 HU
Value of Hounsfield units measured by chest computed tomography for assessing bone density in the thoracolumbar segment of the thoracic spine.
Study design: A retrospective study.
Purpose: To investigate the correlation between Hounsfield unit (HU) values measured by chest computed tomography (CT) and dual-energy Xray absorptiometry (DXA) T-scores. HU-based thoracolumbar (T11 and T12) cutoff thresholds were calculated for a cohort of Chinese patients.
Overview of literature: For patients with osteoporosis, the incidence of fractures in the thoracolumbar segment is significantly higher than that in other sites. However, most current clinical studies have focused on L1.
Methods: This retrospective study analyzed patients who underwent chest CT and DXA at our hospital between August 2021 and August 2022. Thoracic thoracolumbar segment HU values, lumbar T-scores, and hip T-scores were computed for comparison, and thoracic thoracolumbar segment HU thresholds suggestive of potential bone density abnormalities were established using receiver operating characteristic curves.
Results: In total, 470 patients (72.4% women; mean age, 65.5±12.3 years) were included in this study. DXA revealed that of the 470 patients, 90 (19%) had osteoporosis, 180 (38%) had reduced osteopenia, and 200 (43%) had normal bone mineral density (BMD). To differentiate osteoporosis from osteopenia, the HU threshold was established as 105.1 (sensitivity, 54.4%; specificity, 72.2%) for T11 and 85.7 (sensitivity, 69.4%; specificity, 61.1%) for T12. To differentiate between osteopenia and normal BMD, the HU threshold was 146.7 for T11 (sensitivity, 57.5%; specificity, 84.4%) and 135.7 for T12 (sensitivity, 59.5%; specificity, 80%).
Conclusions: This study supports the significance of HU values from chest CT for BMD assessment. Chest CT provides a new method for clinical opportunistic screening of osteoporosis. When the T11 HU is >146.7 or the T12 HU is >135.7, additional osteoporosis testing is not needed unless a vertebral fracture is detected. If the T11 HU is <105.1 or the T12 HU is <85.7, further DXA testing is strongly advised. In addition, vertebral HU values that fall faster than those of the T11 and L1 vertebrae may explain the high incidence of T12 vertebral fractures.