诊断学理论与实践

诊断学理论与实践 >

2025 , Vol. 24 >Issue 02: 163 - 169

DOI: https://doi.org/10.16150/j.1671-2870.2025.02.007

论著

基于光子计数探测器CT能谱定位像定量评估股骨颈骨密度的前瞻性研究

  • 周山税 ,
  • 秦乐 ,
  • 常蕊 ,
  • 杜联军 ,
  • 严福华 ,
  • 刘方韬
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  • 1.上海交通大学医学院附属瑞金医院放射科，上海 200025
    2.上海交通大学医学院医学技术学院医学影像技术系，上海 200025
刘方韬 E-mail：lft40620@rjh.com.cn

收稿日期: 2024-12-16

  录用日期: 2025-02-28

  网络出版日期: 2025-07-11

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Prospective study on quantitative evaluation of femoral neck bone mineral density using spectral localizer radiograph from photon-counting detector CT

  • ZHOU Shanshui ,
  • QIN Le ,
  • CHANG Rui ,
  • DU Lianjun ,
  • YAN Fuhua ,
  • LIU Fangtao
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  • 1. Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
    2. Faculty of Medical Imaging Technology, College of Health Science and Technology, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China

Received date: 2024-12-16

  Accepted date: 2025-02-28

  Online published: 2025-07-11

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摘要

目的： 研究基于光子计数探测器CT（photon-counting detector CT， PCD-CT）采集的能谱定位像（spectral localizer radiograph， SLR）定量检测股骨颈的面积骨密度（areal bone mineral density， aBMD）的效能。 方法： 于2024年7月至2025年4月前瞻性纳入需接受双能量X射线吸收法（dual-energy X-ray absorptiometry， DXA）以及CT扫描这2种检查的受试者（≥18岁）。这些患者在PCD-CT上接受检查获取SLR，由2名观察者在SLR上独立、盲法测量患者左侧股骨颈的aBMD。以DXA的测量结果为标准，评估SLR对aBMD的定量准确性及针对异常骨量（T值<-1.0）的诊断效能。 结果： 本研究共纳入63名受试者（其中女性36人），平均年龄（64.30±13.20）岁，DXA测得的中位aBMD值为0.889 ［四分位间距（interquartile range， IQR）为0.749～1.031］ g/cm2，其中23人（36.51%）表现出异常骨量。2名观察者测量的aBMD值［中位数（IQR）表示］分别为0.879 （0.760～0.985） g/cm2和0.891 （0.784～0.977） g/cm2，基于SLR测量的aBMD值具有极好的观察者间一致性（组内相关系数为0.98）。以DXA结果为参考，SLR测量aBMD的中位百分比绝对误差为6.66% （IQR为3.64%～9.80%），基于SLR诊断异常骨量的准确率、灵敏度、特异度分别为95.24%（50/63）、95.65%（22/23）、95.00%（38/40）。 结论： 基于PCD-CT采集的能谱定位像可以准确定量股骨颈的骨密度，并表现出较高的异常骨量诊断效能。

关键词： 光子计数CT; 能谱成像; 骨质疏松; 定位像

本文引用格式

周山税 , 秦乐 , 常蕊 , 杜联军 , 严福华 , 刘方韬 . 基于光子计数探测器CT能谱定位像定量评估股骨颈骨密度的前瞻性研究[J]. 诊断学理论与实践, 2025 , 24(02) : 163 -169 . DOI: 10.16150/j.1671-2870.2025.02.007

Abstract

Objective To evaluate the performance of spectral localizer radiograph (SLR) acquired by photon-counting detector CT (PCD-CT) for the quantitative assessment of areal bone mineral density (aBMD) in the femoral neck. Methods From July 2024 to April 2025, subjects (≥18 years old) scheduled for both dual-energy X-ray absorptiometry (DXA) and CT scans were prospectively enrolled. All subjects underwent PCD-CT examinations to obtain SLR, and two observers independently performed blinded measurements of the aBMD in the left femoral neck on the SLR. The measurement results of DXA were used as the reference standard to evaluate the quantitative accuracy of SLR for aBMD and its diagnostic performance for abnormal bone mass (T-score<-1.0). Results A total of 63 subjects (36 females) were enrolled, with a mean age of 64.30±13.20 years. The median aBMD measured by DXA was 0.889 [interquartile range (IQR), 0.749-1.031] g/cm2, and 23 subjects (36.51%) showed abnormal bone mass. The aBMD values measured by the two observers were 0.879 (0.760-0.985) g/cm2 and 0.891 (0.784-0.977) g/cm2, respectively. SLR-based measurements of aBMD demonstrated excellent inter-observer agreement (intraclass correlation coefficient = 0.98). Using DXA results as the reference, the median absolute percentage error of aBMD measured by SLR was 6.66% (IQR, 3.64%-9.80%). The diagnostic accuracy, sensitivity, and specificity of SLR for diagnosing abnormal bone mass were 95.24% (50/63), 95.65% (22/23), and 95.00% (38/40), respectively. Conclusions Spectral localizer radiographs acquired by PCD-CT can accurately quantify bone mineral density in the femoral neck and demonstrate high diagnostic performance for abnormal bone mass.

Key words： Photon-counting detector CT; Spectral imaging; Osteoporosis; Localizer radiograph

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