Unreported Vertebral Body Compression Fractures at Abdominal Multidetector CT
Unreported Vertebral Body Compression Fractures at Abdominal Multidetector CT
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DOI：
10.1148/radiol.13121632
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发表时间：
2013-07-01
期刊：
影响因子：
19.7
通讯作者：
Pickhardt, Perry J.
中科院分区：
文献类型：
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作者：
Carberry, George A.;Pooler, B. Dustin;Pickhardt, Perry J.
目的：回顾性评估未报告的椎体压缩性骨折在腹部CT（CT）的患病率和临床结局：材料和方法：这符合健康保险责任法案的研究机构审查委员会批准，需要知情同意放弃了这项回顾性分析。在2000年至2007年期间，在常规获得矢状面CT重建之前，共有2041例连续成人患者（1640例女性，401例男性;年龄范围，19-94岁）在6个月内接受了腹部多探测器CT和双能X线吸收测定法（DXA）。使用Genant视觉半定量方法，对下胸椎和腰椎的横向（轴向）和回顾性矢状面多探测器CT重建进行了审查，以确定是否存在中度或重度椎体压缩性骨折。26例患者因病理性骨折或限制压缩性骨折检测的技术因素而被排除。对中度或重度压缩性骨折患者的电子病历进行了审查，以确定骨折是否在前瞻性CT判读时报告，之前已知或随后诊断。与中心DXA T评分相关。统计学分析进行了学生t检验和Fisher精确test.Results：至少有一个中度或重度椎体压缩性骨折被确定在CT回顾性97例（平均年龄，70.8岁）。67例患者发生单节段骨折，30例患者发生多节段骨折，共计141例骨折。在81例（84%）患者中，未进行前瞻性CT诊断。前瞻性报告骨折的患者年龄明显较大，更可能有严重的压缩性骨折（P
Purpose: To retrospectively assess the prevalence and clinical outcomes of unreported vertebral compression fractures at abdominal computed tomography (CT).Materials and Methods: This HIPAA-compliant study had institutional review board approval; the need for informed consent was waived for this retrospective analysis. A total of 2041 consecutive adult patients (1640 women, 401 men; age range, 19-94 years) underwent both abdominal multidetector CT and dual-energy x-ray absorptiometry (DXA) within 6 months of each other between 2000 and 2007, before sagittal CT reconstructions were obtained routinely. Transverse (axial) and retrospective sagittal multidetector CT reconstructions were reviewed for the presence of moderate or severe vertebral body compression fractures of the lower thoracic and lumbar spine by using the Genant visual semiquantitative method. Twenty-six patients were excluded for evidence of pathologic fracture or for technical factors limiting compression fracture detection. Electronic medical records were reviewed for patients with moderate or severe compression fractures to determine whether the fracture was reported at prospective CT interpretation, was known previously, or was diagnosed subsequently. Correlation was made with central DXA T scores. Statistical analysis was performed with the Student t test and Fisher exact test.Results: At least one moderate or severe vertebral body compression fracture was identified retrospectively at CT in 97 patients (mean age, 70.8 years). Fractures involved one level in 67 and multiple levels in 30 patients, for a total of 141 fractures. In 81 (84%) patients, prospective CT diagnosis was not made. Patients in whom fractures were reported prospectively were significantly older and were more likely to have a severe compression fracture (P