Abstract：Objective To obtain the reference CT values of bone marrow in adults' normal thoracolumbar vertebrae by using bone marrow imaging virtual non-calcium technique in dual-source dual-energy CT.Methods Together 200 individuals who received physical examination between August 2016 and November 2016 in Qilu Hospital of Shandong University were prospectively recruited to perform thoracolumbar bone marrow imaging on dual-source dual-energy CT. All the subjects were divided into male and female groups of <45 years old and ≥45 years old, with 50 individuals in each group. The bone marrow CT values (HU) of T3-L5 vertebrae body were measured through the virtual non-calcium technique, and then, according to the approximate degree, above measured CT values of each vertebral body were divided into T3-T5, T6-T9, T10-L1, L2-L5, followed by calculating the mean values. Finally, differences in bone marrow CT values regarding as age and gender were also analyzed by using the independent sample t test.Results The bone marrow CT values of thoracic and lumbar vertebrae in the <45 years old group were (-29.00±10.62) HU and (-35.81±12.36) HU, respectively, which were both higher than those in the ≥45 years old group with (-41.67±17.16) HU and (-44.81±14.35) HU, and the differences were significant (t=-6.326, -4.746, all P values<0.01). The bone marrow CT values of thoracic and lumbar vertebrae in the <45 years old female group were significantly higher than those in the ≥45 years old female group [(-27.76±9.55) HU and (-37.56±9.05) HU vs. (-37.80±15.97) HU and (-45.45±14.04) HU], and the differences were significant (t=3.818, 3.339, all P values <0.01). The bone marrow CT values of thoracic and lumbar vertebrae in the <45 years old male group were (-30.73±12.16) HU and (-33. 91±14.64) HU, respectively, which were also significantly higher than those in the ≥45 years old male group with (-46.07±17.42) HU and (-44.68±14.84) HU, and the differences were significant (t=5.105, 3.653, all P values<0.05). For thoracic vertebrae, there was no significant difference in bone marrow CT values in both female and male groups of <45 years old (P>0.05), but except for that in the ≥45 years old group (t=2.474, P<0.05); as for lumbar vertebrae, there was no significant difference in CT values of bone marrow in both female and male either in the <45 years old or ≥45 years old groups (all P values >0.05). The measured bone marrow CT values both in thoracic and lumbar vertebrae were negatively correlated with age (r=-0.463, -0.402, all P values<0.01). The average bone marrow CT values of T3-T5, T6-T9, T10-L1, and L2-L5 in the <45 years old group were all higher than those in the ≥45 years old group, and the differences were statistically significant (all P values <0.01). However, statistical differences were only observed between bone marrow CT values of segments of T6-T9 and T10-L1 vertebrae in the ≥45 years old group (t=3.177, -2.326, all P values<0.05) when compared between genders, and other CT values did not approach significant difference (all P values>0.05). The average CT dose index volume and dose length product values were 4.53-18.79 (8.73±2.98) mGy and 117.34-1678.42(421.53±230.85)mGy·cm, respectively, and meanwhile the effective radiation dose in this study was (6.35 ± 3.43) mSv.Conclusions Reference thoracolumbar vertebrae bone marrow CT values are stable, which may provide an objective quantitative standard for vertebral disease diagnosis. Meanwhile, the radiation dose is not very high or even decreased.
王红, 方家杨, 郭丽娟, 向颖, 李笃民, 王青, 于德新. 成人正常胸、腰椎体双源双能CT虚拟去钙骨髓成像量化标准值研究[J]. 中华解剖与临床杂志, 2018, 23(1): 21-26.
Wang Hong, Fang Jiayang, Guo Lijuan, Xiang Ying, Li Dumin, Wang Qing, Yu Dexin. Reference CT values of bone marrow in adults' normal thoracolumbar vertebrae on dual-source dual-energy CT virtual noncalcium technique. Chinese Journal of Anatomy and Clinics, 2018, 23(1): 21-26.
Nicolaou S, Liang T, Murphy DT, et al. Dual-energy CT: a promising new technique for assessment of the musculoskeletal system[J]. AJR Am J Roentgenol, 2012, 199(5 Suppl): S78-S86. DOI:10.2214/AJR.12.9117
[2]
Omoumi P, Verdun FR, Guggenberger R, et al. Dual-energy CT: basic principles, technical approaches, and applications in musculoskeletal imaging (Part 1) [J]. Semin Musculoskelet Radiol, 2015, 19(5): 431-437. DOI:10.1055/s-0035-1569253
[3]
Omoumi P, Verdun FR, Guggenberger R, et al. Dual-energy CT: basic principles, technical approaches, and applications in musculoskeletal imaging (Part 2) [J]. Semin Musculoskelet Radiol, 2015, 19(5): 438-445. DOI:10.1055/s-0035-1569252
[4]
Wang CK, Tsai JM, Chuang MT, et al. Bone marrow edema in vertebral compression fractures: detection with dual-energy CT[J]. Radiology, 2013, 269(2): 525-533. DOI:10.1148/radiol. 13122577
[5]
Bierry G, Venkatasamy A, Kremer S, et al. Dual-energy CT in vertebral compression fractures: performance of visual and quantitative analysis for bone marrow edema demonstration with comparison to MRI[J]. Skeletal Radiol, 2014, 43(4): 485-492. DOI:10.1007/s00256-013-1812-3
Pache G, Bulla S, Baumann T, et al. Dose reduction does not affect detection of bone marrow lesions with dual-energy CT virtual noncalcium technique[J]. Acad Radiol, 2012, 19(12): 1539-1545. DOI:10.1016/j.acra.2012.08.006
[11]
James B, 汤路佳. 骨髓成像(上)[J]. 国外医学(临床放射学分册), 1989(6): 343-346
[12]
James B, 汤路佳. 骨髓成像(下)[J]. 国外医学(临床放射学分册), 1990(1): 29-32
[13]
Ting Ma H, Griffith JF, Yang Z, et al. Effect of vertebral morphology on lumbar kinematics in elderly subjects with decreased bone mineral density[J]. Conf Proc IEEE Eng Med Biol Soc, 2008, 2008: 883-886. DOI:10.1109/IEMBS.2008.4649295
[14]
Wang YX, Zhang YF, Griffith JF, et al. Vertebral blood perfusion reduction associated with vertebral bone mineral density reduction: a dynamic contrast-enhanced MRI study in a rat orchiectomy model[J]. J Magn Reson Imaging, 2008, 28(6): 1515-1518. DOI:10.1002/jmri.21539
[15]
Griffith JF, Yeung DK, Ma HT, et al. Bone marrow fat content in the elderly: a reversal of sex difference seen in younger subjects[J]. J Magn Reson Imaging, 2012, 36(1): 225-230. DOI:10.1002/jmri.23619
2018, Vol. 23 
