Effect of IV contrast on lumbar trabecular attenuation at routine abdominal CT: correlation with DXA and implications for opportunistic osteoporosis screening.

摘要: Osteoporosis remains under-diagnosed. Routine abdominal CT can provide opportunistic screening, but the effect of IV contrast is largely unknown. The overall performance for predicting osteoporosis was similar between enhanced and unenhanced scans. Therefore, both non-contrast contrast-enhanced scans be employed screening. an important yet under-diagnosed public health concern. Lumbar attenuation measurement at routine a simple initial screen, has not been fully evaluated. Mean trabecular values (in Hounsfield units, HU) L1 vertebral level were measured by oval region-of-interest (ROI) on IV-contrast-enhanced series in 157 adults (mean age, 62.0). All patients underwent correlative central DXA within 6 months CT. Based BMD lumbar spine, femoral neck, total proximal femur: osteoporosis, osteopenia, normal present 33, 77, 47, respectively. Statistical analysis included Bland-Altman plots receiver operating characteristic (ROC) curves. difference (±SD) +11.2 HU (±19.2) (95 % CI, 8.16–14.22 HU), 8 % difference. Intra-patient variation substantial, no trend HU seen according to underlying BMD. ROC area under curve (AUC) diagnosing 0.818 0.830, respectively (p = 0.632). Thresholds maintaining 90 % specificity 90 HU 102 HU sensitivity 139 HU 144 HU Similar diagnostic low (osteoporosis or osteopenia) using higher cut-offs. Contrast-enhanced shows average increase 11 HU over attenuation. scans, thus either