老年男性腰椎的QCT骨密度测量

目的:探讨老年男性腰椎定量CT(QCT)骨密度(BMD)测量的价值及其应用中的注意事项。方法:对516例老年男性进行腰椎体松质骨的QCT骨密度测量。检查时通过L_(1～5)椎体中心和腰椎体模中心行轴位扫描。然后对各椎体及体模图像进行测量。所得数据由腰椎骨密度分析软件分析处理,得出个体腰椎的平均骨密度值及T-Score值、Z-Score值,再将其结果与正常人群的骨密度峰值进行比较,经分析得出诊断结论。诊断标准参照WHO的标准及国内推荐的标准执行。结果:516例中骨密度正常者24例,占4.7%;骨密度降低者109例,占21.1%;骨质疏松症者318例,占61.6%;严重骨质疏松症者65例,占12.6%。结论:腰椎体松质骨的QCT骨密度测量可较早地反映出老年男性体内骨矿含量的变化,对早期发现和确诊老年男性的骨质疏松症具有十分重要的价值。在QCT检查中,需高度重视测量质量的控制。

Bone mineral density measurement of lumbar vertebrae by QCT in elderly male

Objeetive.. To evaluate the value of using QCT to measure BMD values of lumbar vertebrae in elderly male and discuss its points for attention in application. Methods.. In 516 elderly men, BMD values of cancellous bone in lumbar vertebral bodies were measured. The axial scans were performed through the center of the L1, L2, L3 , L4 , L5 vertebral bodies and the lumbar vertebral phantoms. Then their images were measured. The data obtained were analysed with the lumbar vertebra BMD software to generate the average BMD values of lumbar vertebrae and the T-Score values, Z-Score values in the cases. Then the results were compared with the peak BMD in population to reach the diagnostic conclusions. The diagnostic standard refers to the WHO criterion and national recommended standard. Results： Among the 516 cases, there were 24 （4.7%） patients with normal BMD, 109 （21.1%） patients with reductive BMD, 318 （61.6%） patients with osteoporosis, and 65 （12. 6%） patients with severe osteoporosis. Conclusion： Using QCT to measure BMD of cancellous bone in lumbar vertebral bodies may early reflect the changes of bone mineral content in elderly male. It has an important value for the early diagnosis of osteoporosis in elderly men. In QCT measure it should be paid great attention to quality control.