| Autor: |
Wentao Lin, Chaoqin He, Faqin Xie, Tao Chen, Guanghao Zheng, Houjie Yin, Haixiong Chen, Zhiyun Wang |
| Rok vydání: |
2023 |
| Předmět: |
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| Zdroj: |
The Spine Journal. 23:295-304 |
| ISSN: |
1529-9430 |
| DOI: |
10.1016/j.spinee.2022.10.014 |
| Popis: |
Level-specific lumbar bone mineral density (BMD) evaluation of a single vertebral body can provide useful surgical planning and osteoporosis management information. Previous comparative studies have primarily focused on detecting spinal osteoporosis but not at specific levels.To compare the detection rate of lumbar osteoporosis between quantitative computed tomography (QCT) and dual-energy X-ray absorptiometry (DXA); to explore and analyze the distribution models of QCT-derived BMD and DXA T-score at the specific levels; and to evaluate the diagnostic accuracy of level-specific BMD thresholds for the prediction of osteoporotic vertebral compression fracture (OVCF) in postmenopausal women.A comparative analysis of prospectively collected data comparing QCT-derived BMD with DXA T-score.A total of 296 postmenopausal women who were referred to the spine service of a single academic institution were enrolled.QCT-derived BMD and DXA T-score at specific levels, with or without osteoporotic vertebral compression fracture.Postmenopausal women who underwent QCT and DXA within a week of admission from May 2019 to June 2022 were enrolled. The diagnostic criteria for osteoporosis recommended by the World Health Organization and the American College of Radiology were used for lumbar osteoporotic diagnosis. To evaluate differences in lumbar BMD measurements at specific levels, a threshold of T score=-2.5 and QCT-derived BMD = 80 mg/cmOf the 296 patients, QCT diagnosed 61.1% as osteoporosis, 30.4% as osteopenia and 8.4% as normal. For those screened with DXA, 54.1% of the patients had osteoporosis, 29.4% had osteopenia and 16.6% had normal BMD. Diagnoses were concordant for 194 (65.5%) patients. Of the other 102 discordant patients, 5 (1.7%) were major and 97 (32.8%) were minor. Significant correlations in level-specific BMD between DXA and QCT were observed (p.001), with Pearson's correlation coefficients ranging from 0.662 to 0.728. The correlation strength was in the order of L1L2L3L4. The low BMD detection rate for QCT was significantly higher than that for DXA at the L3 and L4 levels (65% vs. 47.9% and 68.1% vs 43.7, respectively, p.001). Patients with OVCF showed significantly lower QCT-derived BMD (47.2 mg/cmQCT provided a more accurate evaluation of lumbar osteoporosis than DXA. The QCT-derived BMD measurements at a specific lumbar level have a high diagnostic performance for OVCF. |
| Databáze: |
OpenAIRE |
| Externí odkaz: |
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