两种QCT骨密度测量软件检测腰椎骨密度的比较

目的 探讨飞利浦工作站IntelliSpace (IP) （无体模）和Mindways (MW) QCT Pro（有体模）两种骨密度测量软件测量腰椎BMD值的重复性、相关性、一致性及其在临床中的应用价值。方法 临床需要进行腹部扫描患者222例，将扫描数据分别传到IP和MW骨密度测量软件进行测量，应用 Pearson 相关性检验分析两种软件测量结果的相关性，应用配对样本 t 检验分析两种方法测量结果平均值是否有差异，应用Bland-Altman 图分析二者的一致性。自222例数据中随机抽取30例，由 2 名测量者在不同时间分别在各自软件上测量2 次椎体BMD 值，评价两个软件测量重复性。结果 重复性研究：IP及MW 对于所选 30 例 2 次测量结果之间均具有显著相关性(r=0.977，P＜0.01) 。2次测量结果之间差异均无统计学意义 (P>0.05) 。IP测量BMD值（92.93±36.16 mg/cm3）显著低于MW测量BMD值（112.78±41.36 mg/ cm3），但两者测量值之间成正相关（r=0.911，P＜0.01），对原始数据进行Bland-Altman 分析，差值大部分位于差值平均值±1. 96 标准差范围内，提示两种测量一致性好。结论 IP骨密度测量软件不能直接采用QCT诊断标准，但其与MW骨密度测量软件的一致性及相关性好，可用于对临床患者骨密度的评价及随访。

Comparison of the detection of bone mineral density of the lumbar vertebrae between two QCT measuring software

Objective To explore the reproducibility, correlation, consistency, and clinical application value of the lumbar BMD measured with Philips workstation IntelliSpace (IP, without phantom) and Mindways (MW) QCT Pro (with phantom), respectively. Methods Two hundred and twenty patients were performed abdominal scan in clinic. The scan data were sent to the IP and MW bone mineral density measurement software for measurement. The Pearson correlation test was used to analyze the correlation between the measurement results of the two software. The paired sample t test was used to analyze whether the average values of the two methods were different. The Bland-Altman chart was used to analyze the consistency of the two. Thirty randomly selected cases were measured twice by different operators using each QCT software to test the reproducibility. Results There was significant correlation between two measurements in 30 randomly selected cases using IP and MW software. Correlation coefficient was 0.977 (P < 0.01) showing high reproducibility. There was no significant difference between the two measurements (P > 0.05). The BMD value measured with IP (92.93±36.16 mg/cm3) was significantly lower than that measured with MW (112.78±41.36 mg/cm3). There was a positive correlation between the two measured values (r=0.911, P<0.01). Bland-Altman analysis showed that most of the differences were within ± 1.96 standard deviations of the mean of the differences, indicating that the two measurements were in good coincidence. Conclusion The consistency and correlation between the IP bone mineral density measurement software and the MW bone mineral density measurement software are good. They can be used for the evaluation and follow-up of bone mineral density of clinical patients.