造影剂用量和 CT 重建平面对评估腰椎潜在骨质的 Hounsfield 单位的影响。

IF 2.9 2区 医学 Q2 CLINICAL NEUROLOGY
Abdelrahman M Hamouda, Zach Pennington, Maria Astudillo Potes, Mahnoor Shafi, Anthony L Mikula, Nikita Lakomkin, Michael L Martini, Mohamad Bydon, Kurt A Kennel, Matthew T Drake, Brett A Freedman, Arjun S Sebastian, Ahmad Nassr, Jeremy L Fogelson, Benjamin D Elder
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引用次数: 0

摘要

目的:与传统的骨质测量方法相比,Hounsfield 单位(HUs)可以更好地预测器械融合术的生物力学并发症。通常使用非对比度轴切片。本研究旨在探讨重建平面和造影剂用量对腰椎成像患者HUs测量值的影响:方法:将未接受过脊柱手术、感染或肿瘤的患者分为三组:1)150 名接受高分辨率非对比度腰椎 CT 检查的患者;2)109 名接受非对比度和对比度增强腰椎 CT 检查的患者;3)100 名接受非对比度腰椎 CT 和腰椎 CT 骨髓造影检查的患者。第 1 组的非对比度 HU 值在轴向、矢状和冠状重建中进行了比较。第 2 组和第 3 组的 HU 值根据轴切片平均值进行比较。组间 HU 值的比较采用 Wilcoxon 符号秩检验,以确定组间是否存在显著的统计学差异(α = 0.05)。线性回归还用于确定非对比轴向 CT 切片的 HU 值与其他序列的 HU 值之间的相关程度:第 1 组患者的平均年龄为 58.8 ± 15.9 岁(54.0% 为男性),第 2 组患者的平均年龄为 65.5 ± 15.9 岁(61.5% 为男性),第 3 组患者的平均年龄为 65.2 ± 14.2 岁(53.5% 为男性)。比较第 1 组的 HU 测量结果发现,除轴向平均测量结果与冠状平均测量结果(P = 0.257)和矢状平均测量结果与中矢状测量结果(P = 0.726)外,其他测量模式之间存在显著差异。对比度腰椎 CT 与非对比度腰椎 CT 之间,以及 CT 髓造影与非对比度 CT 之间,每个椎体的平均轴向 HU 值都存在明显差异。线性回归分析表明,所有方法的测量值之间具有极高的相关性(r2 = 0.950-0.986,所有 p <0.001),对比增强和非对比研究之间也具有极高的相关性(r2 = 0.870,p <0.001)。CT髓核造影的测量值与非对比造影的测量值呈显著相关,但相关程度较低(r2 = 0.745,p < 0.001):结论:非对比 CT 的 HU 测量结果在多个不同平面上显示出相似性,这表明采用更简单的方法(如在中矢状重建上进行单片测量)可以更快速地评估潜在骨质。与之前的研究结果一致,对比增强 CT 序列似乎能可靠地反映潜在的骨质情况,但 CT 髓图测量结果可能会以更难以预测的方式变化,从而无法用于解释潜在的骨质情况。对比增强研究的 HU 值平均更大,这表明需要更高的临界值。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Impact of contrast administration and CT reconstruction plane on Hounsfield units for assessing underlying bone quality in the lumbar spine.

Objective: Hounsfield units (HUs) may better predict biomechanical complications of instrumented fusion than conventional bone quality measures. Typically, noncontrast axial slices are used. This study aims to address the influence of reconstruction plane and contrast administration on measured HUs in patients undergoing lumbar spine imaging.

Methods: Patients without prior spine surgery, infection, or tumor were identified for 3 groups: 1) 150 patients with high-resolution noncontrast lumbar CT, 2) 109 patients with noncontrast and contrast-enhanced lumbar CT, and 3) 100 patients with noncontrast lumbar CT and lumbar CT myelograms. Noncontrast HU measures in group 1 were compared between axial, sagittal, and coronal reconstructions. HU measures for groups 2 and 3 were compared on axial slice averages. HU measures between groups were compared using the Wilcoxon signed-rank test to investigate the presence of a statistically significant difference between groups (α = 0.05). Linear regression was also used to determine the degree of correlation between HU measures on noncontrast axial CT slices and HU measures on other sequences.

Results: The mean patient age was 58.8 ± 15.9 years for group 1 (54.0% male), 65.5 ± 15.9 years for group 2 (61.5% male), and 65.2 ± 14.2 years (53.5% male) for group 3. Comparison of HU measures in group 1 showed significant differences across measurement modalities with the exception of axial average versus coronal average measures (p = 0.257) and sagittal average versus midsagittal measures (p = 0.726). There were significant differences in average axial HUs for each vertebral body between contrast and noncontrast lumbar CT and between CT myelography and noncontrast CT. Linear regression analysis demonstrated an extremely high correlation between measures for all methodologies (r2 = 0.950-0.986, all p < 0.001), and between contrast-enhanced and noncontrast studies (r2 = 0.870, p < 0.001). Measurements on CT myelography were significantly correlated with those in noncontrast studies, although to a lesser degree (r2 = 0.745, p < 0.001).

Conclusions: HU measures on noncontrast CT appear similar across multiple different planes, suggesting that a simpler methodology such as single-slice measurement on midsagittal reconstruction may allow for more rapid assessment of underlying bone quality. Consistent with prior work, contrast-enhanced CT sequences appear to reliably mirror underlying bone quality, although CT myelogram measures may vary in a more unpredictable way that precludes their use to interpret underlying bone quality. HU measures on contrast-enhanced studies are on average greater, suggesting the need for higher cutoff values.

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来源期刊
Journal of neurosurgery. Spine
Journal of neurosurgery. Spine 医学-临床神经学
CiteScore
5.10
自引率
10.70%
发文量
396
审稿时长
6 months
期刊介绍: Primarily publish original works in neurosurgery but also include studies in clinical neurophysiology, organic neurology, ophthalmology, radiology, pathology, and molecular biology.
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