Assessment of volumetric bone mineral density of the femoral neck in postmenopausal women with and without vertebral fractures using quantitative multi-slice CT |
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| Authors: | Sheng-yong Wu Hui-hui Jia Didier Hans Jing Lan Li-ying Wang Jing-xue Li Yue-zeng Cai |
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| Institution: | (1) Department of Radiology, Tianjin First Central Hospital, Tianjin, 300192, China;(2) Department of Radiology, General Hospital of Tianjin Medical University, Tianjin, 300052, China;(3) Center of Bone Diseases, Department of Bone and Joint, Lausanne University Hospital, 1011 Lausanne, Switzerland |
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| Abstract: | Objective To demonstrate the validity and reliability of volumetric quantitative computed tomography (vQCT) with multi-slice computed
tomography (MSCT) and dual energy X-ray absorptiometry (DXA) for hip bone mineral density (BMD) measurements, and to compare
the differences between the two techniques in discriminating postmenopausal women with osteoporosis-related vertebral fractures
from those without.
Methods Ninety subjects were enrolled and divided into three groups based on the BMD values of the lumbar spine and/or the femoral
neck by DXA. Groups 1 and 2 consisted of postmenopausal women with BMD changes <−2SD, with and without radiographically confirmed vertebral fracture (n=11 and 33, respectively). Group 3 comprised normal controls with BMD changes ≥−1SD (n=46). Post-MSCT (GE, LightSpeed16) scan reconstructed images of the abdominal-pelvic region, 1.25 mm thick per slice, were
processed by OsteoCAD software to calculate the following parameters: volumetric BMD values of trabecular bone (TRAB), cortical
bone (CORT), and integral bone (INTGL) of the left femoral neck, femoral neck axis length (NAL), and minimum cross-section
area (mCSA). DXA BMD measurements of the lumbar spine (AP-SPINE) and the left femoral neck (NECK) also were performed for
each subject.
Results The values of all seven parameters were significantly lower in subjects of Groups 1 and 2 than in normal postmenopausal women
(P<0.05, respectively). Comparing Groups 1 and 2, 3D-TRAB and 3D-INTGL were significantly lower in postmenopausal women with
vertebral fracture(s) (109.8±9.61) and (243.3±33.0) mg/cm3, respectively] than in those without (148.9±7.47) and (285.4±17.8) mg/cm3, respectively] (P<0.05, respectively), but no significant differences were evident in AP-SPINE or NECK BMD.
Conclusion the femoral neck-derived volumetric BMD parameters using vQCT appeared better than the DXA-derived ones in discriminating
osteoporotic postmenopausal women with vertebral fractures from those without. vQCT might be useful to evaluate the effect
of osteoporotic vertebral fracture status on changes in bone mass in the femoral neck.
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| Keywords: | Osteoporosis Bone mineral density (BMD) Volumetric QCT Hip fracture Postmenopausal women |
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