Converted Lumbar BMD Values Derived from Sagittal Reformations of Contrast-Enhanced MDCT Predict Incidental Osteoporotic Vertebral Fractures

Lumbar Vertebrae Middle Aged 03 medical and health sciences 0302 clinical medicine Bone Density Multidetector Computed Tomography Humans Spinal Fractures Female Longitudinal Studies Osteoporosis, Postmenopausal Osteoporotic Fractures Aged Follow-Up Studies
DOI: 10.1007/s00223-012-9596-3 Publication Date: 2012-04-06T10:34:41Z
ABSTRACT
We obtained baseline and follow-up bone mineral density (BMD) values of the lumbar spine from sagittal reformations of routine abdominal contrast-enhanced multidetector computed tomography (MDCT) using a reference phantom and assessed their performance in differentiating patients with no, existing, and incidental osteoporotic fractures of the spine. A MDCT-to-QCT (quantitative computed tomography) conversion equation for lumbar BMD measurements was developed by using 15 postmenopausal women (63 ± 12 years), who underwent standard lumbar QCT (L1-L3) and afterward routine abdominal contrast-enhanced MDCT. Sagittal reformations were used for corresponding lumbar BMD measurements. The MDCT-to-QCT conversion equation was applied to baseline and follow-up routine abdominal contrast-enhanced MDCT scans of 149 postmenopausal women (63 ± 10 years). Their vertebral fracture status (no, existing, or incidental osteoporotic fracture) was assessed in the sagittal reformations. A correlation coefficient of r = 0.914 (p < 0.001) was calculated for the BMD values of MDCT and standard QCT with the conversion equation BMD(QCT) = 0.695 × BMD(MDCT) - 7.9 mg/mL. Mean follow-up time of the 149 patients was 20 ± 12 months. Fifteen patients (10.1 %) had an existing osteoporotic vertebral fracture at baseline. Incidental osteoporotic vertebral fractures were diagnosed in 13 patients (8.7 %). Patients with existing and incidental fractures showed significantly (p < 0.05) lower converted BMD values (averaged over L1-L3) than patients without fracture at baseline and at follow-up. In this longitudinal study, BMD values of the lumbar spine derived from sagittal reformations of routine abdominal contrast-enhanced MDCT predicted incidental osteoporotic vertebral fractures.
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