Viet Anh Nguyen, Chi Sun, Haocheng Xu, Hongli Wang, Xiaosheng Ma, Feizhou Lu, Jianyuan Jiang
Purposes: The purpose of this study was to evaluate CT HU value in specific regions of the Lumbar Spine and investigate the correlation between their CT HU values and the corresponding bone quality index provided by Dual-Energy X-ray Absorptiometry (DEXA).3
Methods: A total of 32 Chinese adults with lumbar degenerative disc disease requiring diagnostic lumbar CT and DEXA at our hospital were retrospectively reviewed in this study. The HU value of medial cortical area (mHU), lateral cortical area (lHU) and trabecular area (tpHU) of the pedicle and superior portion, middle portion, inferior portion of the vertebral body (sHU, mbHU, iHU, respectively) were measured on CT images. T score and BMD score of each vertebra were also measured by DEXA. The HU value was compared between sex groups, vertebra and the correlations of HU value with DEXA T-score; DEXA BMD-score were analyzed.
Results: In vertebral body, the value of mHU is the lowest (p<0.001) while mbHU and iHU are not significantly different. The tpHU had the lowest HU value compared to mHU and lHu. mHU had significantly higher value than lHU at all levels (p<0.001). The value of mHU and lHU is found correlated with T-scores (p<0.01) at all lumbar levels. The value of tpHU is not correlated with either T-scores or BMD (p>0.05). The HU values of all vertebral body regions at all lumbar levels (sHU,mbHU,iHU) correlate strongly with T-scores and BMD(r>0.6, p<0.01).
Conclusion: CT HU value could be a reliable indicator for regional bone quality, especially in people with lumbar degenerative changes. The superior portion of the lumbar vertebra had the lowest bone density in comparison with other regions of the vertebra at L1-L4. In lumbar pedical, the medial lateral cortical bone area had higher bone density than the lateral cortical bone and trabecula bone area.
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