Objective To investigate the difference of detection rate of osteoporosis using quantitative CT ( QCT ) and dual X-ray absorptiometry ( DXA ) in elderly males. Methods 59 elderly males were recruited consecutively in this study. The age ranged from 54 to 92 years. All of the subjects underwent spine and hip DXA scan, and lumbar spinal QCT within one month. Results According to the WHO DXA - 2. 5 SD and ISCD QCT < 80 mg/cm3 osteoporosis diagnosis criteria, the detection rate of osteoporosis using DXA were 0% , 8. 5% and 8. 5% at PA spine, any femur, and any site, respectively. The detection rate of QCT was 35. 6% . Twenty one subjects ( 35. 6% ) were diagnosed as osteoporosis by QCT, but not by spinal PA DXA and 3 of them had osteoporotic vertebral fractures, 16 subjects ( 27. 1% ) were diagnosed as osteoporosis by QCT, but not by DXA at any femur and any site. Conclusion QCT is superior to DXA in detecting osteoporosis in elderly males.%目的 评估腰椎定量CT与双能X线骨密度测量诊断老年男性骨质疏松的效能.方法 连续选取2012年2月至2012年8月期间于北京积水潭医院干部科住院的老年男性患者,共59例,年龄54~92岁.本组病例均行腰椎正位和髋关节DXA及腰椎QCT检查,且两项检查间隔时间不超过1个月.结果采用世界卫生组织(WHO)DXA -2.5 SD和国际临床骨密度学会(ISCD)腰椎QCT<80 mg/cm3的骨质疏松诊断标准,DXA诊断本组病例腰椎、髋关节及腰椎或髋关节任一部位骨质疏松的检出率分别为0%、8.5%和8.5%.腰椎QCT诊断本组病例骨质疏松的检出率为35.6%.其中腰椎QCT诊断为骨质疏松而腰椎正位DXA未诊断者21例,占35.6%,其中3例CT显示有骨质疏松性椎体骨折;腰椎QCT诊断为骨质疏松而髋关节DXA或任一部位DXA未诊断者均为16例,占27.1%.结论腰椎QCT比髋关节DXA及腰椎正位DXA对老年男性骨质疏松的诊断更敏感.腰椎QCT骨密度测量对老年男性的骨质疏松诊断具有较高的临床价值.
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