CAJ | 학술논문

目的：研究双能量 X 线（dual X-ray absorptionery， DXA）骨密度测量与定量 CT （quantitative computed tomography， QCT）骨密度测量在诊断围绝经期妇女骨质疏松中的差异，探讨围绝经期妇女椎体骨密度（bone mineral density，BMD）与椎体平均CT值的相关性，确定椎体平均 CT值诊断骨量减少及骨质疏松的阈值。方法选择45～55岁的围绝经期妇女，对其进行常规椎体CT扫描及 QCT骨密度检查，测量椎体平均CT值和 QCT平均BMD值及T值；对部分研究对象同时进行进行 QCT检查和 DXA检查。结果纳入课题研究对象361例，平均年龄49.6岁，平均 T 值-1.18，平均 SMD 值为127.4，椎体平均 CT 值为137.1 HU，椎体CT值、T 值和平均 BMD 值间有高度相关性（相关系数分别为0.74、0.84，P 值均小于0.01）。以小于-1.0和-2.5分别作为诊断骨量减少和骨质疏松的标准，共检出骨量减少和骨质疏松分别为165例和53例，发病率分别为45.7％、14.7％；分别以椎体平均CT值为145 HU和110 HU作为诊断骨量减少和骨质疏松的阈值，诊断骨量减少和骨质疏松的灵敏度和特异度分别为87.2％、80.7％和90％、92.6％，约登指数分别为0.68、0.83；43例同时行 QCT与DXA检查，在检出骨量减少和骨质疏松的病人差异有统计学意义。结论椎体平均CT值与 QCT测得的椎体平均BMD值及T值具有高度相关性，椎体平均CT值可以代表QCT的T值和BMD值，反映围绝经期妇女骨量丢失程度。
목적：연구쌍능량 X 선（dual X-ray absorptionery， DXA）골밀도측량여정량 CT （quantitative computed tomography， QCT）골밀도측량재진단위절경기부녀골질소송중적차이，탐토위절경기부녀추체골밀도（bone mineral density，BMD）여추체평균CT치적상관성，학정추체평균 CT치진단골량감소급골질소송적역치。방법선택45～55세적위절경기부녀，대기진행상규추체CT소묘급 QCT골밀도검사，측량추체평균CT치화 QCT평균BMD치급T치；대부분연구대상동시진행진행 QCT검사화 DXA검사。결과납입과제연구대상361례，평균년령49.6세，평균 T 치-1.18，평균 SMD 치위127.4，추체평균 CT 치위137.1 HU，추체CT치、T 치화평균 BMD 치간유고도상관성（상관계수분별위0.74、0.84，P 치균소우0.01）。이소우-1.0화-2.5분별작위진단골량감소화골질소송적표준，공검출골량감소화골질소송분별위165례화53례，발병솔분별위45.7％、14.7％；분별이추체평균CT치위145 HU화110 HU작위진단골량감소화골질소송적역치，진단골량감소화골질소송적령민도화특이도분별위87.2％、80.7％화90％、92.6％，약등지수분별위0.68、0.83；43례동시행 QCT여DXA검사，재검출골량감소화골질소송적병인차이유통계학의의。결론추체평균CT치여 QCT측득적추체평균BMD치급T치구유고도상관성，추체평균CT치가이대표QCT적T치화BMD치，반영위절경기부녀골량주실정도。
Objective To study the clinical value of perimenopausal women osteoporosis with vertebra bone mineral density (BMD)by quantitative computed tomography (QCT)and dual X-ray absorptionery (DXA),while exploring perimenopausal women vertebral bone mineral density (Bone mineral density, BMD) and vertebral average correlation of CT values to determine the average CT value in diagnosing ver-tebral bone loss and osteoporosis threshold.Methods Perimenopausal women with age of 45~55 were chosen for routine CT scans and QCT vertebral bone density testing,average CT value and QCT vertebral BMD values and T values were measured and arown into figure, and QCT and DXA examination were made on part of subjects.Results 361 cases were included in this study with 49.6 mean age,and mean T-score was 1.18,and T-score was 127.4 with vertebral average CT value 137.1HU.Vertebral CT and T values had high correlation with that of average BMD (correlation coefficients were 0.74,0.84,P val-ues less than 0.01).In 165 cases and 53 cases were detected osteopenia and osteoporosis taking respective less than-1.0 and-2.5 as standards. Hence the incidence rates were 45.7%, 14.7%. Consequently, taking average CT value 145HU vertebral and 110HU as respectively,diagnostic osteopenia and osteopo-rosis thresholds, diagnostic, sensitivity and specificity of osteopenia and osteoporosis were 87.2%, 80.7% and 90%,92.6%,Youden index were 0.68,0.83.Detecting bone loss and osteoporosis patients by QCT and DXA in 43 case had statistical significance.Conclusion QCT vertebral mean CT values, measured mean BMD and vertebral T values are highly correlated, vertebral average CT value can repre-sent values of T and QCT BMD values,reflecting Perimenopausal women lose bone mass level.