| 童小雨,刘义军,王旭,李贝贝,范勇,王诗耕,陈安良.应用Auto-prescription技术采集胸部低剂量定量CT对骨质状态判断的影响[J].中国介入影像与治疗学,2023,20(3):180-184 |
| 应用Auto-prescription技术采集胸部低剂量定量CT对骨质状态判断的影响 |
| Impact of Auto-prescription technique applicated in chest low dose quantitative CT for judging bone status |
| 投稿时间：2022-09-27 修订日期：2022-12-04 |
| DOI：10.13929/j.issn.1672-8475.2023.03.013 |
| 中文关键词: 骨质疏松 骨密度 体层摄影术,X线计算机 自动管电压调制 |
| 英文关键词:osteoporosis bone density tomography, X-ray computed automatic tube voltage modulation |
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| 中文摘要: |
| 目的 观察基于Auto-prescription技术采集胸部个体化低剂量定量CT （QCT）对椎体骨密度（BMD）的影响及其用于判断骨质状态的效能。方法 前瞻性收集接受胸腹部CT平扫的483例患者。以Auto-prescription技术推荐的最佳管电压进行胸部扫描（A组），并分为A1（80 kVp，n=262）及A2（100 kVp，n=221）组；采用常规120 kVp扫描腹部，对应A1及A2组分为B1、B2组；测量T11~L1共1 449个椎体BMD。比较A1组与B1组、A2与B2组间BMD值的差异，分析其相关性，构建线性回归方程。分别以B1及B2组（管电压均为120 kVp）结果为标准，分析低kVp条件下椎体BMD评价骨质状态的一致性，并采用受试者工作特性（ROC）曲线评估依据低kVp条件下椎体BMD判断骨质状态的效能。结果 A1与B1组、A2与B2组间椎体BMD值差异均有统计学意义（Z=－10.688、-7.710，P均<0.001），且均呈正相关（rs=0.996、0.998，P均<0.001），相应线性回归方程分别为Y （BMD120 kVp）=1.056×BMD80 kVp-4.611及Y （BMD120 kVp）=1.047×BMD100 kVp-4.228。以管电压80 kVp及100 kVp条件下与120 kVp条件下所获椎体BMD判断骨质状态的一致性好（Kappa=0.959、0.960，P均<0.001），其诊断骨质疏松的曲线下面积（AUC）均为1，诊断骨量减低的AUC分别为0.996及0.999。结论 利用Auto-prescription技术采集胸部低剂量QCT对椎体BMD有一定影响，而判断骨质状态的效能较好。 |
| 英文摘要: |
| Objective To observe the impact of Auto-prescription technology applicated in chest low dose quantitative CT (QCT) on vertebral bone mineral density (BMD) and the efficacy for judging bone status. Methods A total of 483 patients planned to undergo chest and abdominal plain CT scanning were prospectively enrolled. Chest CT was performed with the best tube voltage recommended by Auto-prescription, and the patients were divided into A1 (80 kVp, n=262) or A2 (100 kVp, n=221) group according to tube voltage. Abdominal CT was performed using conventional 120 kVp, and patients were divided into B1 or B2 group corresponding to A1 and A2 group. BMD values of T11-L1, totally 1 449 vertebral bodies were measured based on chest and abdominal CT. Vertebral BMD values were compared between A1 group and B1 group, as well as between A2 group and B2 group, and the correlations were analyzed, then the linear regression equations were constructed. Taken the results of B1 group and B2 group (both tube voltage was 120 kVp), the consistency of vertebral BMD under low kVp condition for judging bone status were analyzed, respectively, and the efficacies for judging bone status was evaluated with receiver operating characteristic (ROC) curves. Results Significant differences of vertebral BMD values were found between A1 group and B1 group, also between A2 group and B2 group (Z=-10.688, -7.710, both P<0.001), both with high positive correlation (rs=0.996, 0.998, both P<0.001). The corresponding linear regression equations were Y (BMD120 kVp)=1.056×BMD80kVp-4.611 and Y (BMD120 kVp)=1.047×BMD100 kVp-4.228, respectively. Vertebral BMD values evaluated with CT under tube voltage of 80 kVp and 100 kVp showed good consistency with that under 120 kVp for judging bone status (Kappa=0.959, 0.960, both P<0.001), and the areas under the curve (AUC) for diagnosing osteoporosis were both 1, for diagnosing low bone mass was 0.996 and 0.999, respectively. Conclusion Auto-prescription technique applicated in chest low dose QCT had certain impact on vertebral BMD, which was efficacy for judging bone status. |
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