摘要
目的通过计算机断层扫描(CT)扫描测量腓骨远端的CT值(Houndsfield Unit,HU),评估老年踝关节骨折患者的骨密度,并探讨骨密度与踝关节骨折的相关性。方法纳入74例老年踝关节骨折患者,根据骨密度分为骨质疏松组、骨质减少组和正常组。测量腓骨远端的CT值,利用受试者工作特征(Receiver Operating Characteristic,ROC)曲线计算出区分组间差异的最佳CT值,并分析腓骨远端CT值与腰椎及股骨近端骨矿物质密度(Bone Mineral Density,BMD)和T值之间的相关性。结果腓骨远端CT值与除L1至L3整体BMD外的其他部位均显著相关,尤其与L2 BMD相关性最高(r=0.555,P<0.001)。各组间CT值差异有统计学意义。根据ROC曲线,当CT值为157.43 HU时,区分骨质疏松组和骨质减少组的曲线下面积为0.808(P<0.001),当CT值为218.47 HU时,区分骨质减少的曲线下面积与正常值的差异为0.698(P<0.001)。结论腓骨远端HU的测量可以有效地反映BMD,腓骨远端CT值与腰椎、股骨近端BMD及T值显著相关。CT值可以潜在预测踝关节骨折患者骨质疏松风险的指标。
Objective Ankle fracture is a common type of fracture with increasing incidence in recent years.It is mainly caused by osteoporosis and has not attracted much attention.This study aimed to measure the Hounsfield units(HU)of the distal fibula by computed tomography(CT)scans,evaluate the bone mineral density(BMD)in patients with ankle fracture,and explore the correlation between BMD and ankle fracture.Methods We enrolled 74 patients with ankle fracture and divided them into osteoporosis,osteopenia,and normal groups according bone density.The examiners measured the HU of the distal fibula and we analysis calculated the best HU to distinguish group differences using the receiver operating characteristic(ROC)curve and analyzed the correlation between HU of the distal fibula and BMD,and T-score of lumbar vertebrae and the proximal femur.Results The HU of the distal fibula was significantly associated with whole parts except BMD of total lumbar,especially with BMD of L2,which had the highest correlation(r=0.555,P<0.001).The differences in HU among the groups were statistically significant.According to the ROC curve,when the HU was 157.43 HU,the area under the curve that distinguished the osteoporosis group from osteopenia group was 0.808(P<0.001),and when the HU was 218.47 HU,the area under the curve that distinguished osteopenia from normal was 0.698(P<0.001).Conclusions The measurement of HU of the distal fibula can accurately reflect the BMD.The HU of the distal fibula is significantly correlated with the bone mineral density and T-score of the lumbar spine and proximal femur.The cut-off value of the HU might be used effectively as an indicator of risk of osteoporosis for patients with ankle fracture.
作者
张泽锋
由晓萱
林树峰
颜逸鹏
郭辉洋
叶晖
Zhang Zefeng;You Xiaoxuan;Lin Shufeng;Yan Yipeng;Guo Huiyang;Ye Hui(Jinjiang Municipal Hospital(Shanghai Sixth People's Hospital Fujian),Quanzhou 362200,Fujian,China;Fujian Orthopaedic Trauma and Reconstruction Clinical Research Center,Quanzhou 362200,Fujian,China;Second Affiliated Hospital of Fujian Medical University,Quanzhou 362000,Fujian,China)
出处
《生物医学转化》
2023年第4期46-53,65,共9页
Biomedical transformation
