QCT椎体骨密度测定诊断骨质疏松症

目的 探讨定量CT(QCT)椎体骨密度(BMD)测定在诊断骨质疏松症中的临床价值和诊断标准.方法 对53例健康无症状中老年人和68例临床拟诊骨质疏松患者进行L1-L4椎体BMD测定.结果 健康中老年人BMD随年龄增长而明显降低,有显著性差异.以BMD≤x-2.0SD为诊断骨质疏松症标准有68例,且各年龄段的BMD值均明显低于骨量截断值;如以BMD≤x-2.5SD为诊断标准则有60例.结论 QCT诊断骨质疏松症敏感、准确、重复性强,易于推广应用.以BMD≤x-2.0SD为诊断标准,更符合临床实际病例,并能减少漏诊.     

中老年人椎体骨密度定量CT测定研究

目的探讨定量CT（quantitative CT,QCT）椎体骨密度（bone mineral density,BMD）测定在诊断骨质疏松症中的临床价值,分析骨质疏松发生率与年龄、性别的关系。方法对597例中老年无症状体检者进行BMD测定,其中男性356例,女性241例,年龄30～89岁,按年龄、性别分组,每10岁为一年龄段。将QCT扫描线分别定位于L1～4椎体中间层面,与椎体上下缘平行扫描。结果中老年人BMD随年龄增高而下降,本组骨质疏松症发生率,女性：50～59岁为54.05%,60～69岁为81.81%,70～79岁为94.74%,80～89岁为100%;男性：50～59岁为25%,60～69岁为50%,70～79岁为64.52%,80～89岁为90.91%。结论 QCT诊断骨质疏松症敏感、准确、重复性强,易于推广应用。骨质疏松症发生率与年龄增加有关,年龄越大,骨质疏松症发生率越高,女性显著高于男性。     

63例QCT腰椎骨骨密度测量与DTX-200双能X前臂骨骨密度测量对比分析

目的 对比同一组检测者,使用DTX-200双能x线骨密度仪测量前臂骨骨密度(hone mineral density,BMD)与QCT测量腰椎骨骨密度的测定结果,发现不同设备,不同部位骨密度测量的差异性和相关性.方法 选取志愿者63例(男性19例,女性43例),分别用DTX-200双能X线骨密度仪测量前臂骨BMD值和T值(n=63),再用QCT测量腰椎骨的BMD值和T值(n=63).分别以QCT测量腰椎骨T值、DTX-200双能X线测量前臂骨T值,进行骨质疏松症诊断(诊断标准1994年WHO制定,T值≥-1.0SD为骨量正常,-2.5SD＜T值＜-1.0SD为骨量减低,T值≤-2.5SD为骨质疏松).用SPSS13.0软件对DTX-200和QCT测量的BMD值和T值,年龄进行相关性分析,对两组骨质疏松诊断结果分别进行一致性分析.结果 两种设备的检测结果BMD均与年龄呈负相关性,相同年龄段QCT测得的BMD较DTX-200测得的BMD要低,40岁以后更为明显,DTX-200与QCT测量的BMD值的相关系数=0.554(P＜0.01),二者骨质疏松症总体诊断符合率为52.4%.结论 DTX-200双能X线测量前臂骨BMD值与QCT测量腰椎骨BMD值密切相关,目前直接使用WHO制定的诊断标准,对QCT与DTX-200的测量结果进行骨质疏松症的诊断是否合适有待进一步探讨,不同的检测设备,不同的检查部位应有不同的诊断标准或换算系数.     

应用QCT探索骨质疏松症诊断及分级诊断标准

目的　应用QCT检测健康成年人腰椎骨密度 ,探索骨质疏松症的诊断及分级诊断标准。方法　采用日本东芝制造 60 0HQ的CT(单能 ) ,对 12个年龄段 (5年为 1段 ) 5 14名 (男 2 0 6人 ,女3 0 8人 )健康志愿者 (除外患有影响骨代谢疾病及严重腰椎疾病者 ) ,进行L3松质骨BMD检测。结果①峰值骨密度位于 3 0岁年龄段 ,男性 (2 2 7 8± 2 7 0 )mg/cm3;女性 (2 40 9± 2 9 0 )mg/cm3。②峰值骨量过后BMD随增龄而逐渐降低 (P <0 0 1) ,至 45岁年龄段时 ,男女均进入骨量减少期 :女性 5 0岁、男性5 5岁年龄段时BMD均值进入骨质疏松期。③骨质疏松诊断标准有二 ,第一 ,BMD测定值比同性别峰值BMD均值降低 2 5SD以上。第二 ,BMD测定值比同性别峰值BMD减少 3 0 %以上可做骨质疏松诊断标准。④首次提出骨质疏松分 4级 (Ⅰ、Ⅱ、Ⅲ、Ⅳ级 )诊断标准及诊断量化表。结论　①QCT诊断骨质疏松具有较高的敏感性、准确性及可重复性。②骨质疏松分级诊断标准 ,给临床诊断、疗效观察及科研提供具体客观指标。③诊断量化表能帮助临床医师直接、准确、快捷的做出骨质疏松症的分级诊断并易于推广应用     

中老年骨质疏松症患者腰1～3椎体骨密度值与CT值相关性研究

目的:探讨骨质疏松症患者腰椎骨密度(BMD)值与CT值的相关性,为临床手术判定及预后评估提供影像学依据.方法:选取在河南省洛阳正骨医院行骨密度检查的204例中老年人为研究对象,其中156例骨质疏松症患者为研究组,48例骨量正常者为对照组.分别运用定量计算机断层扫描法(QCT)测量腰1～3椎体平均BMD值及CT值,对两者...     

新疆石河子地区汉族中老年人骨质疏松患病率调查

原发性骨质疏松症严重危害着中老年人的身体健康,发病率较高。为了解我区发病情况,本采用单光子骨矿测定仪对本地区584名汉族中老年人行骨矿含量测定。结果显示：男女性40岁以后骨密度(BMD）随年龄增长而逐年下降,骨量与年龄呈负相关。以峰值骨量头减少2．0SD为骨质疏松的诊断标准,50－59年龄段男性患病率为5．7％,女性为33．3％;60－69年龄段男性患病率达25％,女性达78．9％。两性间差异有显性（P＜0．01）;女性发病率为男性2．73倍。研究表明：本地区中老年男女性随年龄增长骨矿丢失明显加速,骨质疏松患病率随之增加,女性发病率明显高于男性。     

单能X线和定量CT测量骨密度的相关性研究

目的：比较跟骨单能X线（SXA）测定值和腰椎定量CT（QCT）测定值的相关性,旨在为临床上合理地应用跟骨SXA测定仪。方法：应用单能X线和定量CT骨密度测定仪测量了201例正常或病人的跟骨及椎体骨密度,对测量结果进性了统计学相关性分析。结果：男女人群SXA和QCT的总相关系数分别为0．653和0．638;P＜0．001,骨质疏松组SXA与QCT的测定值有非常显的相关性（P＜0．001）,骨量正常组和骨量减少组则无显的相关性（P＞0．05）,从年龄上40岁以上女性与60岁以上男性SXA与QCT的测定值有非常显的相关性。结论：SXA测定不能代替QCT测定,但SXA机型小,轻便且价廉,尤其在40岁以上的女性和在60岁以上的老年男性,以及患有面骨质疏松的病人,他们的测量结果与QCT有着显的相关性,故在临床上不失为诊断绝经后妇女和老年性骨质疏松的一种手段。     

成年男性骨质疏松症的病例筛选与防治对策探讨

目的 探讨重庆地区中老年男性骨质疏松症的病例筛选、诊断以及对本地区中老年男性骨质疏松与骨质疏松性骨折的防治措施。方法 对180例不同程度出现常见的骨质疏松症状的40岁以上成年男性，使用双能X线骨密度仪（DXA）进行骨密度（BMD）测定。按年龄段（10年）分组统计BMD值，观察各年龄段骨质疏松与骨折发生情况。结合 病史及受检人群的社会、行为因素与疾病情况进行分析，提出病例筛选、诊断与防治措施。结果 重庆地区40岁以上的男性患者，出现常见的骨质疏松症状，或X片有骨质疏松改变，进行DXA检查骨质疏松症患者（T-score≤-2．5SD）的检出率较高。40岁到69岁期间的患骨质疏松症的男性人群，骨质疏松性骨折的发病随年龄段上升呈缓慢增加趁势，70岁以后的骨质疏松症患者骨折发生率明显增加（P〈0．01）。男性人群中存在日常膳食钙摄人量低、活动锻炼少、嗜烟酒等不良行为因素影响较普遍；部分人患有可能影响骨代谢异常的重叠性疾病。结论 40岁以后的成年男性临床出现常见的骨质疏松症状，X片检查提示骨质疏松改变，如果DXA骨密度测定T值低于-2．5SD，诊断为骨质疏松症较为客观。除高龄的因素外，成年男性人群中膳食钙含量低，缺少运动，不良嗜好，患影响骨代谢的疾病及环境因素等，都可能加快中老年男性骨矿物质的丢失过早患骨质疏松症。保持健康的生活、饮食习惯与针对性的药物治疗都是重要的防治措施。     

绝经妇女腰椎及髋关节定量cT骨密度测量诊断骨质疏松的初步研究

目的比较绝经后妇女L2-L4椎体及髋关节两个部位的定量CT骨密度（BMD )测量诊断骨 质疏松的效能。方法175例绝经妇女,年龄48-96岁,平均年龄为69 ±9岁。同时QCT测量L2-L4椎体的平均体积骨密度及髋关节类DXA的面积骨密度,右股骨颈和全髋二个感兴趣区（ROI )。 采用国际临床骨密度学会（ISCD )QCT骨质疏松诊断标准（<80 mg/cm3 )和WHO髋关节DXA骨密 度诊断标准即股骨颈或全髋感兴趣区的T值（-2.5 SD )进行骨质疏松诊断。比较二者诊断骨质疏 松的效能。结果175绝经后妇女中,QCT骨密度测量腰椎部位骨密度值骨质疏松的检出率是44%( 77/175 )。如果采用髋部检查股骨颈部位为11%.( 19/175 ),全髋部位为14%.( 24/175 ),或二者任一 部位为18%_( 31/175 )。如果只做腰椎,不做髋关节,有7人漏诊,而如果只做髋关节,不做腰椎会漏 诊44人。结论采用QCT骨密度测量,绝经妇女腰椎检查骨质疏松检出率为44%_,而髋部检查检出 率为18%_。采用QCT骨密度测量,测量腰椎一个部位就可以诊断骨质疏松。     

运用定量CT对老年女性腰椎间盘突出症与椎体骨密度的相关性研究

目的：运用定量CT研究老年女性腰椎间盘突出症患者和健康体检者腰椎骨密度（ bone mineral density,BMD）的差异,探讨骨密度对腰椎间盘突出症的影响。方法选取腰椎间盘突出症患者64例,健康体检者60例作为对照,使用定量CT （ quantitative CT,QCT）测定两组人群腰椎相同部位骨密度,比较分析两组间、组内骨密度值。结果腰椎间盘突出症患者的骨密度值较对照组低,骨量减少及骨质疏松者在腰椎间盘突出症组所占比例较高,但差异无统计学意义（ P＞0．05）。腰椎间盘突出组中椎间盘邻近上下两椎体间骨密度有差异（ P＜0．05）,而对照组则无明显差异。结论骨密度对腰椎间盘突出症有一定的影响,突出的椎间盘邻近两椎体骨密度存在某种特殊差异可能是造成椎间盘突出的一种原因。     

腰椎体积CT值对诊断骨质疏松症的应用价值

目的 评估基于双层光谱CT腰椎扫描获得的椎体体积HU值在骨质疏松诊断中的应用价值。方法 回顾性收集2022年10月至2023年3月北京积水潭医院脊柱外科门诊患者91例。所有患者均接受过腰椎双层光谱CT扫描,包括QCT。同时测量纳入患者L1和L2椎体的体积HU值和基于QCT扫描的体积骨密度值。依据腰椎QCT骨密度诊断骨质疏松症的标准将研究对象分为骨量正常组、低骨量组和骨质疏松组,比较3组患者的一般情况,分析体积HU值与QCT测量的体积骨密度的关系。使用ROC曲线分别计算体积HU值诊断骨量减少和骨质疏松最佳诊断阈值以及使用逻辑回归模型确定性别、年龄和体积HU值与骨质疏松发生的关系。结果 L1和L2的平均体积HU值与QCT测量的BMD之间有极好的相关性（r= 0.941, P<0.001）;ROC诊断骨量减少和骨质疏松的最佳阈值分别为154.73 HU（灵敏度为92.9 %）和106.52 HU（灵敏度为86.6 %）;年龄和基于双层光谱CT测量的体积HU值与骨质疏松的发生显著相关（P<0.001）,OR值分别为1.172和0.928。结论 基于双层光谱CT测量的体积HU值和QCT测量的体积BMD之间有较好的相关性;基于腰椎体积HU值的阈值能准确预测骨量异常减低和骨质疏松,因此,体积HU值可以作为临床机会性筛查骨质疏松的补充手段。     

575例体检者QCT椎体骨密度测定分析

[目的]对体检中筛查出的椎体骨量减少、骨质疏松症患者,分析其发生率与年龄、性别的关系。[方法]使用定量CT(QCT)对575例体检者进行腰椎骨密度检测并分析。研究数据使用SAS 9.0进行统计分析。[结果]40岁以后椎体骨矿物含量(BMD)随年龄增高而下降。本组骨质疏松症发生率,女性:50~59岁以上56.34%,60~69岁以上87.80%,70~79岁以上97.22%,80~89岁以上100%;男性:50~59岁以上25.44%,60~69岁以上50.64%,70~79岁以上66.66%,80~89岁以上90.91%。[结论]骨质疏松症发生率与年龄增加有关,年龄越大,骨质疏松症发生率越高。女性显著高于男性。     

mDIXON-Quant技术评估中老年女性骨质量的临床研究

目的 探讨中老年女性腰椎骨髓脂肪分数(fat fraction,FF)和T2?值与骨密度(bone mineral density,BMD)的关联性及mDIXON-Quant技术对骨量下降的诊断效能.方法 招募中老年女性健康志愿者共126名,采用双能X线吸收测量仪(dual-energy X-ray absorptio...     

老年2型糖尿病双能X线及定量CT测量骨密度的临床分析

目的 探讨老年2型糖尿病临床与不同骨密度(BMD)测定方法之间的关系和特点。方法 测定45例老年2型糖尿病患者的空腹(FBG)及餐后血糖(PBG)、糖化血红蛋白(HbAlc)、胆固醇(TC)、甘油三脂(TG)、骨钙素(BGP)、血清Ⅰ型胶原C端肽(CICP)、血清骨特异性碱性磷酸酶(B-ALP)、尿吡啶啉(Pyd)、脱氧吡啶啉(D-Pyd)、尿羟脯胺酸(Hyp),对同一病人同时行双能X线测定(DEXA)及定量CT测定(QCT),并进行分组比较。结果 本组45例病人中同时用DEXA及QCT测定骨密度均有骨质疏松者18例,占45％(18/40),其中男性4例,女性14例,女性占骨质疏松组的77.78％(14/18)。单用DEXA测量出骨质疏松者23例,单用QCT测量出骨质疏松者21例,其中5例有2例示QCT正常,而用DEXA测定有骨质疏松;3例用QCT测定已有腰椎骨质疏松,而DEXA示腰椎正常,但股骨颈部有骨质疏松。结论 老年2型糖尿病的骨质疏松与糖尿病病程、餐后血糖、胆固醇密切相关。骨形成指标(BGP、CICP)在骨质疏松组中非但不降,反比非骨质疏松组有明显升高。本研究显示老年2型糖尿病同时用DEXA及QCT测定骨密度有很好的相关性,r=0.770,P<0.01,故仅做腰椎QCT也可作为老年2型糖尿病骨质疏松的诊断依据。     

Preoperative MRI-based vertebral bone quality (VBQ) score assessment in patients undergoing lumbar spinal fusion

BACKGROUND CONTEXTThe importance of bone status assessment in spine surgery is well recognized. The current gold standard for assessing bone mineral density is dual-energy X-ray absorptiometry (DEXA). However, DEXA has been shown to overestimate BMD in patients with spinal degenerative disease and obesity. Consequently, alternative radiographic measurements using data routinely gathered during preoperative evaluation have been explored for the evaluation of bone quality and fracture risk. Opportunistic quantitative computed tomography (QCT) and more recently, the MRI-based vertebral bone quality (VBQ) score, have both been shown to correlate with DEXA T-scores and predict osteoporotic fractures. However, to date the direct association between VBQ and QCT has not been studied.PURPOSEThe objective of this study was to evaluate the correlation between VBQ and spine QCT BMD measurements and assess whether the recently described novel VBQ score can predict the presence of osteopenia/osteoporosis diagnosed with QCT.STUDY DESIGN/SETTINGCross-sectional study using retrospectively collected data.PATIENT SAMPLEPatients undergoing lumbar fusion from 2014-2019 at a single, academic institution with available preoperative lumbar CT and T1-weighted MRIs were included.OUTCOME MEASURESCorrelation of the VBQ score with BMD measured by QCT, and association between VBQ score and presence of osteopenia/osteoporosis.METHODSAsynchronous QCT measurements were performed. The average L1-L2 BMD was calculated and patients were categorized as either normal BMD (>120 mg/cm³) or osteopenic/osteoporotic (≤120 mg/cm³). The VBQ score was calculated by dividing the median signal intensity of the L1-L4 vertebral bodies by the signal intensity of the cerebrospinal fluid on midsagittal T1-weighted MRI images. Inter-observer reliability testing of the VBQ measurements was performed. Demographic data and the VBQ score were compared between the normal and osteopenic/osteoporotic group. To determine the area-under-curve (AUC) of the VBQ score as a predictor of osteopenia/osteoporosis receiver operating characteristic (ROC) analysis was performed. VBQ scores were compared with QCT BMD using the Pearson's correlation.RESULTSA total of 198 patients (53% female) were included. The mean age was 62 years and the mean BMI was 28.2 kg/m². The inter-observer reliability of the VBQ measurements was excellent (ICC of 0.90). When comparing the patients with normal QCT BMD to those with osteopenia/osteoporosis, the patients with osteopenia/osteoporosis were significantly older (64.9 vs. 56.7 years, p<.0001). The osteopenic/osteoporotic group had significantly higher VBQ scores (2.6 vs. 2.2, p<.0001). The VBQ score showed a statistically significant negative correlation with QCT BMD (correlation coefficient = -0.358, 95% CI -0.473 - -0.23, p<.001). Using a VBQ score cutoff value of 2.388, the categorical VBQ score yielded a sensitivity of 74.3% and a specificity of 57.0% with an AUC of 0.7079 to differentiate patients with osteopenia/osteoporosis and with normal BMD.CONCLUSIONSWe found that the VBQ score showed moderate diagnostic ability to differentiate patients with normal BMD versus osteopenic/osteoporotic BMD based on QCT. VBQ may be an interesting adjunct to clinically performed bone density measurements in the future.     

Bone mass continues to increase at the hip after parathyroid hormone treatment is discontinued in glucocorticoid-induced osteoporosis: results of a randomized controlled clinical trial.

Glucocorticoid-induced osteoporosis is the most common secondary cause of osteoporosis. In this 24-month study, we report changes in bone turnover and bone mass after 12 months of daily injections of human parathyroid hormone 1-34 [hPTH(1-34)] and 12 months off treatment in postmenopausal women (mean age, 63 years) with osteoporosis treated with glucocorticoid and hormone replacement therapy. Response to the treatment was assessed with bone mineral density (BMD) measurements of the lumbar spine by quantitative computed tomography (QCT); BMD measurements of the lumbar spine, hip, and forearm by dual-energy X-ray absorptiometry (DXA); and biochemical markers of bone turnover. The mean (+/-SEM) change in BMD of the lumbar spine by QCT and DXA in the PTH group at 24 months was 45.9+/-6.4% and 12.6+/-2.2% (p < 0.001). The change in total hip and femoral neck BMD was not significant at 12 months but increased to 4.7+/-0.9% (p < 0.01) and 5.2+/-1.3% at 24 months, respectively, as compared with a relatively small change of 1.3+/-0.9% and 2.6+/-1.7% in the estrogen-only group. The mean percent differences in BMD of the lumbar spine by QCT and DXA between the groups at 24 months were 43.1% and 11.9%, respectively (p < 0.001). The mean percent differences over the estrogen-only group in hip BMD were 3.4% for total hip (p < 0.01) and 2.6% for femoral neck at 24 months. Biochemical markers of bone turnover increased to more than 150% during the first 6 months of therapy, remained elevated throughout the 12-month treatment period, and returned to baseline values within 6 months of discontinuing the PTH treatment. These results suggest that PTH dramatically increases bone mass in the lumbar spine and hip in postmenopausal women with glucocorticoid-induced osteoporosis who are taking hormone replacement therapy. However, the maximum effect of this anabolic agent on bone mass at the hip after 12 months of treatment requires at least 6-12 months after the PTH treatment is discontinued.     

定量CT骨密度测定在中老年男性中的应用研究

目的探讨定量CT(quantitative computed tomography,QCT)骨密度测定在中老年男性中的应用价值。方法收集常规查体、年龄50岁以上的男性138例。每例患者均进行血清学指标检测、QCT和双能X线吸收检测法(DXA)骨密度测定。结果随年龄增加,QCT骨密度及DXA的股骨颈骨密度均呈下降趋势(P<0.05)。QCT方法检出低骨量69例(50.0%),骨质疏松27例(19.6%),而DXA方法检出骨量减少43例(31.2%),骨质疏松4例(2.9%),两种方法的检出率差异具有明显统计学意义(P<0.01)。在不同年龄组,QCT均比DXA对骨量减少的检出率高,且随年龄增加检出率逐渐升高(P<0.01)。结论中老年男性QCT较DXA骨密度测定的骨量减少检出率更高,随年龄增加检出率增加,QCT的方法可能更适于中老年男性骨质疏松防治过程中的检测。     

Feasibility of Opportunistic Screening for Low Thoracic Bone Mineral Density in Patients Referred for Routine Cardiac CT

Despite being a frequent and treatable disease, osteoporosis remains under-diagnosed worldwide. Our study aim was to characterize the bone mineral density (BMD) status in a group of patients with symptoms suggestive of coronary artery disease (CAD) with low/intermediate risk profile undergoing routine cardiac computed tomography (CT) to rule out CAD. This cross-sectional study used prospectively acquired data from a large consecutively included cohort. Participants were referred for cardiac CT based on symptoms of CAD. Quantitative CT (QCT) dedicated software was used to obtain BMD measurements in 3 vertebrae starting from the level of the left main coronary artery. We used the American College of Radiology cut-off values for lumbar spine QCT to categorize patients into very low (<80 mg/cm3), low (80-120 mg/cm3), or normal BMD (>120 mg/cm3). Analyses included 1487 patients. Mean age was 57 years (range 40-80), and 52% were women. The number of patients with very low BMD was 105 women (14%, 105/773) and 74 men (10%, 74/714). The majority of patients with very low BMD was not previously diagnosed with osteoporosis (87%) and received no anti-osteoporotic treatment (90%). Opportunistic screening in patients referred for cardiac CT revealed a substantial number of patients with very low BMD. The majority of these patients was not previously diagnosed with osteoporosis and received no anti-osteoporotic treatment. Identification of these patients could facilitate initiation of anti-osteoporotic treatment and reduce the occurrence of osteoporosis-related complications     

Simultaneous screening for osteoporosis at CT colonography: Bone mineral density assessment using MDCT attenuation techniques compared with the DXA reference standard

The purpose of this study was to evaluate the utility of lumbar spine attenuation measurement for bone mineral density (BMD) assessment at screening computed tomographic colonography (CTC) using central dual‐energy X‐ray absorptiometry (DXA) as the reference standard. Two‐hundred and fifty‐two adults (240 women and 12 men; mean age 58.9 years) underwent CTC screening and central DXA BMD measurement within 2 months (mean interval 25.0 days). The lowest DXA T‐score between the spine and hip served as the reference standard, with low BMD defined per World Health Organization as osteoporosis (DXA T‐score ≤ ?2.5) or osteopenia (DXA T‐score between ?1.0 and ?2.4). Both phantomless quantitative computed tomography (QCT) and simple nonangled region‐of‐interest (ROI) multi‐detector CT (MDCT) attenuation measurements were applied to the T₁₂–L₅ levels. The ability to predict osteoporosis and low BMD (osteoporosis or osteopenia) by DXA was assessed. A BMD cut‐off of 90 mg/mL at phantomless QCT yielded 100% sensitivity for osteoporosis (29 of 29) and a specificity of 63.8% (143 of 224); 87.2% (96 of 110) below this threshold had low BMD and 49.6% (69 of 139) above this threshold had normal BMD at DXA. At L₁, a trabecular ROI attenuation cut‐off of 160 HU was 100% sensitive for osteoporosis (29 of 29), with a specificity of 46.4% (104 of 224); 83.9% (125 of 149) below this threshold had low BMD and 57.5% (59/103) above had normal BMD at DXA. ROI performance was similar at all individual T₁₂–L₅ levels. At ROC analysis, AUC for osteoporosis was 0.888 for phantomless QCT [95% confidence interval (CI) 0.780–0.946] and ranged from 0.825 to 0.853 using trabecular ROIs at single lumbar levels (0.864; 95% CI 0.752–0.930 at multivariate analysis). Supine‐prone reproducibility was better with the simple ROI method compared with QCT. It is concluded that both phantomless QCT and simple ROI attenuation measurements of the lumbar spine are effective for BMD screening at CTC with high sensitivity for osteoporosis, as defined by the DXA T‐score. © 2011 American Society for Bone and Mineral Research     

DXA、QCT和SPA方法测量47例绝经后妇女骨质疏松症的比较

以骨密度测量应用最广的３种方法（ＤＸＡ─双能ｘ线吸收法，ＱＣＴ─定量ＣＴ法和ＳＰＡ─单光子吸收法）测量绝经后妇女的骨矿密度，比较其测量值、诊断结果和相关关系。首先用ＳＰＡ法测量绝经后妇女１８１例，诊断骨质疏松（ＯＰ）４７例。三种方法测量骨矿密度的均值分别低于峰值骨量的Ｍ─２ｓ的９％、２１．４％和２１％，且ＤＸＡ和ＱＣＴ两种方法测量的均值都在骨折阈值范围内。ＤＸＡ和ＱＣＴ诊断４７例ＯＰ之间无显著性差异，当排除椎骨骨质增生后的ｘ２＝０．２３７，且ＤＸＡ和ＱＣＴ测量值之间为正相关，ｒ＝０．７９９，而ＤＸＡ、ＱＣＴ和ＳＰＡ之间的相关系数，ｒ＝０．１８５和０．２８５，ＤＸＡ诊断ＯＰ的敏感性为８６．６％，特异性为７０％。