能谱CT定量钙（水）密度技术对腰椎椎体内及椎体间骨密度差异的研究

Intra and inter vertebral calcium (water) density variation measured by Gemstone Spectral Imaging

关键词:  计算机断层成像  钙（水）密度  能谱成像  腰椎

Key words:  [Key words]　computed tomography(CT)  calcium (water) density  GSI  lumbar vertebra

摘要:

[摘要]　目的　探讨受检者腰椎椎体内不同感兴趣区（ROI）的骨密度差异和Ｌ1～3椎体在不同年龄段间的骨密度差异，来完善能谱CT定量钙（水）密度技术在腰椎测量方面的方法，并了解各腰椎椎体骨密度随年龄变化的差异。　方法　筛选2013年1月—2014年12月期间行腰椎CT能谱GSI扫描的男性237例，按10岁为一个年龄段分为6组。由两位放射医师分别测量Ｌ1～3椎体上中下3个层面的钙（水）密度，应用方差分析组内差异；同时分别计算Ｌ1～3椎在不同年龄段的平均值，应用方差分析每个年龄段各椎体骨密度的组间差异。　结果　Ｌ1～3椎体上中下3个层面骨密度分别为（mg/mL）：L1：54.94±8.82，58.22±6.19，59.92±5.78；L2：55.38±7.67，56.66±8.48，60.23±6.80；L3：54.67±7.69，55.89±5.78，58.75±4.83；每个椎体内3个层面间比较，差异均有显著性意义，腰椎最上层面密度最低。50～59岁和60～69岁年龄段L3椎体骨密度（54.26±6.14）mg/mL，（45.2±9.88）mg/mL低于L1、2椎体骨密度为（57.24±6.93）mg/mL，（48.16±10.36）mg/mL，L2为（55.82±7.65）mg/mL，（47.81±10.23）mg/mL，70～79岁Ｌ1～3椎各椎体骨密度均略有回升。　结论　腰椎椎体内骨密度存在区域性差异，Ｌ3椎体可以作为老年骨质疏松筛查的首选椎体。

Abstract:

[Abstract]　Objective　To discuss calcium (water) density[DCa(Wa)]　variation of the same lumbar vertebral body (L1, L2 and L3) in different levels and evaluate correlation between L1-3 DCa(Wa) and age by gemstone spectral imaging(GSI).　Methods　This study included 237 male patients who underwent spinal GSI examination with spectral CT (Discovery CT 750HD, GE). They had no trauma, surgery, tumor or other diseases affecting bone mineral density (such as metabolic or endocrine diseases, chronic renal failure, diseases of the spine, etc). All patients were divided into six groups according to age (20-29, 30-39, 40-49, 50-50, 60-69, over 70). All patients were measured the DCa(Wa) in L1-3 vertebral bodies of different levels by two radiologists. ANOVA study was used to analyze the variance within the vertebra of three levels and the variance among vertebra (L1-L3) in different ages.　Results　In every vertebra (L1-L3), the DCa(Wa) values in three levels were statistically significant; the upper level of vertebra (L1-L3) was the lowest. In age 50-69 group, the L3 vertebral body DCa(Wa) was the lowest; in age 70-79 group, all vertebra (L1-L3) DCa(Wa) values increased slightly.　Conclusion　There are DCa(Wa) value differences in vertebral body (L1-L3). L3 vertebral body can be used as the preferred senile osteoporosis screening vertebral body.