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Multidetector Computed Tomography in Patients with Femoral Neck Fracture for Assessing Osteoporosis: Comparison with Dual Energy X-Ray Absorptiometry

대퇴골 경부 골절 환자에서 골다공증 평가를 위한 다중검출 CT의 이용: 이중에너지 X-선 흡수계측법과의 비교

  • Hyo Jeong Lee (Department of Radiology, Ewha Womans University, School of Medicine) ;
  • Ji Young Hwang (Department of Radiology, Ewha Womans University, School of Medicine)
  • 이효정 (이화여자대학교 의과대학 영상의학교실) ;
  • 황지영 (이화여자대학교 의과대학 영상의학교실)
  • Received : 2019.12.12
  • Accepted : 2020.04.24
  • Published : 2021.01.01

Abstract

Purpose To evaluate the ability of the Hounsfield unit (HU) measurement of the femoral neck during multidetector computed tomography (MDCT) for assessing osteoporosis compared with dual-energy X-ray absorptiometry (DXA). Materials and Methods Forty-two patients with femoral neck fractures who underwent MDCT and DXA from July to December 2016 were included in this study. HU measurements were made of the cancellous portions of the normal contralateral femoral neck on MDCT. Bone mineral density (BMD) and T-scores were obtained at the femur DXA. Correlations of HU values with BMD and T-scores were analyzed using Spearman's correlation test. Results The mean BMD and T-score of the femoral neck were 0.650 g/cm2 and -2.4, respectively. The mean HU values for the normal, osteopenia, and osteoporosis groups were 131.9, 98.9, and 41.3, respectively. HU values at the femoral neck were positively correlated with BMD (r2 = 0.670; p < 0.001) and T-scores (r2 = 0.676; p < 0.001). Conclusion The HU values of the femoral neck on MDCT are significantly correlated with BMD and T-scores of femur DXA. The HU values may serve as a diagnostic tool for the screening of regional bone quality when MDCT is performed for other reasons.

목적 대퇴골 경부 골절 환자를 대상으로 골다공증 평가를 위해 다중검출 전산화단층촬영(multidetector computed tomography; 이하 MDCT)에서의 감쇠 계수(Hounsfield unit; 이하 HU)와 이중 에너지 X선 흡수 계측법(dual energy X-ray absorptiometry; 이하 DXA)을 비교하였다. 대상과 방법 2016년 6월부터 12월까지 MDCT와 DXA를 모두 시행한 42명의 대퇴골 경부 골절 환자가 본 연구의 대상으로 포함되었다. MDCT에서는 정상 대퇴골 경부의 해면골에서 HU를 측정하였으며 DXA에서는 동 부위의 골밀도 및 T 값을 얻었다. HU와 골밀도 및 T 값의 상관관계를 Spearman 상관계수를 이용하여 분석하였다. 결과 대퇴골 경부 골절 환자의 골밀도와 T 값의 평균은 각각 0.650 g/cm2과 -2.4이었다. 정상, 골감소증, 골다공증 환자 군의 HU의 평균은 각각 131.9, 98.9, 41.3이었다. HU는 골밀도(r2 = 0.670; p < 0.001) 및 T 값(r2 = 0.676; p < 0.001) 모두와 양의 상관관계를 보였다. 결론 다중검출 전산화단층촬영에서 감쇠계수의 측정은 골다공증 선별검사를 위한 유용한 진단적 도구가 될 수 있다.

Keywords

Acknowledgement

We thank professor Ji Eun Park (Asan Medical Center) for providing software and useful discussions on the study.

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