scholarly journals Accuracy of Computed Tomography Attenuation Value of Lumbar Vertebra to Assess Bone Mineral Density

2021 ◽  
Vol 28 (1) ◽  
pp. 41-50
Author(s):  
Kok King Chia ◽  
Juhara Haron ◽  
Nik Fatimah Salwati Nik Malek
Keyword(s):  
Computed Tomography ◽  
Diagnostic Accuracy ◽  
Lumbar Vertebra ◽  
Region Of Interest ◽  
Hounsfield Unit ◽  
Mineral Density ◽  
Roc Curve Analysis ◽  
Cross Sectional ◽  
T Score ◽  
Contrast Enhanced Ct

Background: Computed tomography (CT) attenuation (Hounsfield unit [HU]) value of lumbar vertebra may provide an alternative method in the detection of osteoporosis during CT scans. Methods: A cross-sectional study on 50 patients of age 50 and above with contrast-enhanced CT (CECT) and dual-energy X-ray absorptiometry (DXA) was conducted from November 2018 to November 2019. Single region of interest (ROI) was placed at the anterior trabecular part of L1 vertebra on CECT to obtain HU value. Correlation of CT HU value of L1 vertebra and DXA T-score, interrater reliability agreement between HU value of L1 vertebra and T-score in determining groups of with and without osteoporosis, ROC curve analysis for diagnostic accuracy and cut-off value of CT for detection of osteoporosis were identified. Results: Significant correlation between HU value of L1 vertebra and L1 T-score (r = 0.683)/lowest skeletal T-score (r = 0.703) (P < 0.001). Substantial agreement between HU value of L1 vertebra and DXA in determining the groups with and without osteoporosis (k = 0.8; P < 0.001). The area under the receiver operating characteristic (AUROC) curve was 0.93 (95% CI: 0.86, 1.00) using HU value (P < 0.001). Cut-off value for osteoporosis was 149 HU. Conclusion: HU value of lumbar vertebra is an effective alternative for the detection of osteoporosis with high diagnostic accuracy in hospitals without DXA facility.

Could Computed Tomography Hounsfield Unit Values of Lumbar Vertebrae Detect Osteoporosis

2021 ◽  
Vol 17 ◽  
Author(s):  
Elif Hocaoglu ◽  
Ercan Inci ◽  
Meltem Vural
Keyword(s):  
Computed Tomography ◽  
Lumbar Vertebrae ◽  
Hounsfield Unit ◽  
Control Group ◽  
Mineral Density ◽  
Lumbar Degenerative Disease ◽  
T Score ◽  
Spinal Osteoporosis ◽  
Spine Degeneration ◽  
Group D

Background: Dual-energy X-ray absorptiometry (DEXA) scanning has several disadvantages determining osteoporosis especially for the degenerative spine. Introduction: To determine spinal osteoporosis in patients suffering from lumbar degenerative disease using computed tomography (CT). Methods: A total of 547 subjects that underwent DEXA and abdominal CT within a period of three months were examined retrospectively and separated into groups based on lumbar degenerative alteration on the CT scan. The subjects that showed degenerative severity at L1–L4, in at least two levels, were graded and placed in the degenerative group (Group D, n=350), while the other subjects constituted the control group (Group C, n=197). The Hounsfield unit (HU) of the vertebral body trabecular bone, the T-score, and bone mineral density (BMD) of L1–L4 and hips were determined from the CT images. CT-HU parameters for osteoporosis acquired from the control group were used to ascertain undiagnosed osteoporosis. Results: The CT-HU was positively correlated with T-score and lumbar BMD for both groups (P<0.001), while the L1–L4 correlation was higher in Group C than in Group D. Based on linear regression, the T-score and CT-HU for L1-L4 osteoporosis were 129, 136, 129 and 120 HU, respectively in Group C. Undiagnosed spinal osteoporosis was greater in Group D compared to the controls (44.2% vs. 9.6%, respectively) based on the CT-HU thresholds. Conclusion: Lumbar spine degeneration can augment BMD and T-score, resulting in the underestimation of lumbar osteoporosis. The osteoporosis threshold determined by CT-HU may be a valuable technique to determine undiagnosed spinal osteoporosis.

Heterogeneity between proximal and distal aspects of occlusive thrombi on pretreatment imaging in acute ischemic stroke

2021 ◽  
pp. 197140092110497
Author(s):  
Tetsuya Hashimoto ◽  
Takenobu Kunieda ◽  
Tristan Honda ◽  
Fabien Scalzo ◽  
Latisha K Sharma ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Ischemic Stroke ◽  
Region Of Interest ◽  
Hounsfield Unit ◽  
Distal Segment ◽  
Large Vessel Occlusion ◽  
Anterior Circulation ◽  
Vessel Occlusion ◽  
The Difference

Background The potential heterogeneity in occlusive thrombi caused by in situ propagation by secondary thrombosis after embolic occlusion could obscure the characteristics of original thrombi, preventing the clarification of a specific thrombus signature for the etiology of ischemic stroke. We aimed to investigate the heterogeneity of occlusive thrombi by pretreatment imaging. Methods Among consecutive stroke patients with acute embolic anterior circulation large vessel occlusion treated with thrombectomy, we retrospectively reviewed 104 patients with visible occlusive thrombi on pretreatment non-contrast computed tomography admitted from January 2015 to December 2018. A region of interest was set on the whole thrombus on non-contrast computed tomography under the guidance of computed tomography angiography. The region of interest was divided equally into the proximal and distal segments and the difference in Hounsfield unit densities between the two segments was calculated. Results Hounsfield unit density in the proximal segment was higher than that in the distal segment (mean difference 4.45; p < 0.001), regardless of stroke subtypes. On multivariate analysis, thrombus length was positively correlated (β = 0.25; p < 0.001) and time from last-known-well to imaging was inversely correlated (β = −0.0041; p = 0.002) with the difference in Hounsfield unit densities between the proximal and distal segments. Conclusions The difference in density between the proximal and distal segments increased as thrombi became longer and decreased as thrombi became older after embolic occlusion. This time/length-dependent thrombus heterogeneity between the two segments is suggestive of secondary thrombosis initially occurring on the proximal side of the occlusion.

Diagnostic Accuracy of HRCT Chest in Detection of Covid-19 Infection Taking PCR as Gold Standard

2021 ◽  
Vol 15 (6) ◽  
pp. 1679-1681
Author(s):  
Afaque Ali ◽  
Majid Shaikh ◽  
Ahsanullah . ◽  
Adeel Ahmed ◽  
Abid Ali Sahito ◽  
...  
Keyword(s):  
Computed Tomography ◽  
High Resolution ◽  
Diagnostic Accuracy ◽  
Predictive Value ◽  
Gold Standard ◽  
Cross Sectional Study ◽  
Radiology Department ◽  
High Resolution Computed Tomography ◽  
Cross Sectional ◽  
Head Of Department

Objective: To determine the diagnostic accuracy of High-resolution computed tomography (HRCT) chest in detection of covid-19 infection taking PCR as gold standard. Study Design: Cross-sectional study Setting: Radiology department of Tabba Hospital, Karachi. Duration: From March 2019 to September 2020 Material and Methods: All the clinically suspected patients of covid-19, of any age, both genders and those referred to radiology for High-resolution computed tomography (HRCT) chest to detect the covid-19 infection were included. After two days, patients’ PCR reports were collected from the ward, after taking informed consent and permission from head of department. The diagnostic accuracy of HRCT was established with respect to sensitivity, PPV, NPV, and specificity by taking PCR as gold standard. All the information was collected via study proforma. Results: Total 70 patients suspected for COVID-19 were studied, and the patients’ mean age was 58.23±9.52 years. Males were in majority 54(77.1%). As per HRCT findings, COVID-19 infection was positive in 46 patients, however, 48 patients were detected positive for COVID-19 infection as per PCR findings. In the detection of COVID-19 infection, HRCT chest showed sensitivity of 91%, specificity of 90%, PPV of 83%, NPV of 84% and diagnostic accuracy of 94%; by taking PCR as gold standard. Conclusion: High-resolution computed tomography (HRCT) is a reliable diagnostic approach in promptly detecting the COVID-19; with 91% sensitivity, 90% specificity, 83% positive predictive value, 84% negative predictive value and 94% diagnostic accuracy. Keywords: Accuracy, HRCT, COVID-19

scholarly journals BMD status of Postmenopausal Women in relation with BMI: A study with 93 cases

2016 ◽  
Vol 17 (2) ◽  
pp. 138-141
Author(s):  
Samira Sharmin ◽  
Mabubul Haque ◽  
Syedur Rahman Miah ◽  
Md Mahbub Ur Rahman ◽  
Jasmine Ara Haque ◽  
...  
Keyword(s):  
Lumbar Spine ◽  
Femoral Neck ◽  
Postmenopausal Women ◽  
Lumbar Vertebrae ◽  
The Body ◽  
Mineral Density ◽  
Cross Sectional ◽  
T Score ◽  
Minimal Trauma ◽  
The Mean

Objectives: Low bone mass is a common disorder in elderly population which predisposes to fracture with minimal trauma. This study was performed to find out the association between the Body Mass Index (BMI) and Bone Mineral Density (BMD) in postmenopausal women.Materials and Methods: This cross sectional study was carried out at Institute of Nuclear Medicine and Allied Sciences Comilla and Mitford, Dhaka over a period of 12 months from January 2013 to December 2013. A total 93 postmenopausal women were enrolled for this study. All postmenopausal women underwent a BMD scan of femoral neck and lumbar vertebrae using a Dual Energy X-ray Absorptiometry (DEXA). Participants were categorized into three groups according to their age and BMI. BMD were expressed base on T-score according to WHO criteria. The relation among BMI, age and BMD were assessed.Results: The results of this study showed that the mean age of the study group was 57.13±7.49 years with range of 46 to 75 years. The most postmenopausal women were in age group 55-65years. The mean BMI of the study subjects were 24.18±5.08 kg/m2 with a range of 15.62 to 36.20 kg/m2. Among 93 subjects osteopenia was greater at lumbar spine (45.2%) with T-score mean±SD-1.83±0.33 and osteoporosis at femoral neck (51.6%) with T-score mean ±SD-3.36±-0.67. Pearson’s correlation coefficient test showed inverse relationship between age and BMD both lumbar spine (r = -0.301, p = 0.003) and femoral neck (r = -0.303, p=0.003) whereas the positive relation between BMI and BMD both at lumbar spine (r=0.338, p=0.001) and femoral neck (r =0.343, p=0.001). These showed that with advancing age, BMD decreases and the risk of osteoporosis increases and with increasing BMI, BMD increases and risk of osteoporosis decreases.Conclusion: The findings of this study portrait that aging and low BMI are risk factors associated with bone loss. So preventive measure should be taken for high risk post menopausal women.Bangladesh J. Nuclear Med. 17(2): 138-141, July 2014

Weak psoas and spine extensors potentially predispose to hip fracture

2020 ◽  
pp. 112070002090433
Author(s):  
Keong-Hwan Kim ◽  
Jun Hee Lee ◽  
Eic Ju Lim
Keyword(s):  
Hip Fracture ◽  
Lumbar Vertebra ◽  
Psoas Muscle ◽  
Hounsfield Unit ◽  
The Body ◽  
Whole Body ◽  
Cross Sectional ◽  
Fracture Group ◽  
Extensor Muscles ◽  
Significant Difference

Introduction: We performed a computed tomography analysis of muscle composition characteristics in hip fracture patients and non-hip fracture controls. Methods: In total, 43 patients (9 men, 34 women) were included in the hip fracture group, matched 1 to 1 with non-hip fracture controls. Muscle cross-sectional areas were measured in axial CT scan at the body level of the 4th lumbar vertebra (L4), intervertebral disc level between the 5th lumbar vertebra and the 1st sacral vertebra (L5-S1) and just below level of the lesser trochanter (LT). Attenuation was also evaluated through the mean Hounsfield unit (HU) in these areas. Results: The cross-sectional area per weight (CSA/Wt, mm2/kg) of psoas muscle and extensor muscles of the spine showed a significant difference between the 2 groups at both L4 (9.7 vs. 12.4, p  < 0.001 and 26.3 vs. 29.2, p  = 0.025) and L5-S1 (9.6 vs. 11.5, p  = 0.001 and 8.8 vs. 10.3, p  = 0.041) levels. In addition, the HU of these muscles differed significantly between the 2 groups at both L4 (33.3 vs. 47.6, p  < 0.001 and 13.7 vs. 30.2, p  < 0.001) and L5-S1 (39.7 vs. 52.6, p  < 0.001 and 3.8 vs. 15.1, p  = 0.012) levels. There was no difference in abdominal wall, gluteal, or thigh compartment musculature between the groups. Conclusions: Poorer quantity and quality of psoas muscle and extensor muscles of the spine rather than whole body muscles may contribute to falls and were characteristic features of the hip fracture patients in this series. These findings should be considered when recommending a preventive exercise and rehabilitation protocol.

scholarly journals Study of prevalence of osteoporosis in males of above 40 years age group attending SMS Hospital, Jaipur

2017 ◽  
Vol 3 (4) ◽  
pp. 837
Author(s):  
Parwez Qureshi ◽  
R. C. Meena ◽  
Jakir Husain ◽  
Gaurav Deshwar ◽  
Vineet Maheshwari ◽  
...  
Keyword(s):  
Vitamin D ◽  
Dietary Habits ◽  
Good Control ◽  
Age Group ◽  
Mineral Density ◽  
Cross Sectional ◽  
T Score ◽  
Vitamin D Levels ◽  
Study Population ◽  
Prevalence Of Osteoporosis

<p class="abstract"><strong>Background:</strong> Whenever osteoporosis is discussed, the focus is on women; men are far less likely to receive a diagnosis of osteoporosis or osteoporotic fracture because of considerable gaps in knowledge on male osteoporosis. The aim and objectives were to study the prevalence of osteoporosis in males of above 40 year age group attending SMS Hospital Jaipur &amp; to explore the influence of various modifiable and non-modifiable risk factors on BMD.</p><p class="abstract"><strong>Methods:</strong> Study Location: SMS Medical College and Hospital, Jaipur. Study design: Hospital based cross sectional study. Study period: April 2015 to December 2016. Sample Size: 200. Work up: After taking ethical clearance and informed verbal consent, demographic and clinical details were noted along with S- calcium, Vitamin D and bone mineral density assessment. Osteoporosis was defined as T score ≤−2.5 bone mass −1 to −2.5 and normal as &gt;−1. Data thus collected was analysed with help of SPSS 22.0 through frequency, percentages, Mean, SD and ANOVA.<strong></strong></p><p class="abstract"><strong>Results:</strong> Prevalence of osteopenia and osteoporosis in the study population was 28.5% and 11.5%. Age wise maximum prevalence was in the age group 71-80 years (31.81%). Prevalence of osteoporosis was more among Muslim community 20.83%, more in low socio economic group (BPL). T score of study population was -0.3705±1.41. The mean BMI, S-Calcium, Vitamin D levels and T score values among osteopenic and osteoporotic patients were statistically highly significant when compared to patients without osteo-penic/porotic changes (p&lt;0.05).</p><p><strong>Conclusions:</strong> Osteoporosis is a silent killer and prevention is better than cure as prevention requires simple steps such as good dietary habits, active life style, good control of systemic disorders, reduced intake of tobacco and alcohol.</p>

scholarly journals Assessment Of Third Ventricular Parameters in Computed Tomography of Head: A Pilot Study in Tertiary Level Hospital

2020 ◽  
Vol 42 (3) ◽  
pp. 82-86
Author(s):  
Umesh P Khanal ◽  
Keshav Sah ◽  
Ram B Chand
Keyword(s):  
Computed Tomography ◽  
Third Ventricle ◽  
Cross Sectional Study ◽  
University Teaching ◽  
Cross Sectional ◽  
Contrast Enhanced Ct ◽  
Contrast Enhanced ◽  
Upper Limits ◽  
Gender And Age ◽  
Enhanced Ct

Introduction Measurement of ventricles of the brain is important for evaluating changes due to growth, ageing, intrinsic and extrinsic pathologies. The aim of this study was to determine the various parameters of the third ventricle and to assess their association with gender and age using computed tomography (CT) scans of head. MethodsThis retrospective, quantitative, cross sectional study was performed in the Department of Radiology and Imaging, Tribhuvan University Teaching Hospital from July to October 2019 (4 months) on images of 100 patients (50 males and 50 females) whose age group were 18-87 years, who underwent non-contrast and contrast enhanced CT scan of head. ResultsThe total mean of width of third ventricle was found to be 0.33±0.09 cm, 0.35±0.10 cm in male and 0.31±0.06 cm in female. Third ventricle width (TVW) showed statistically significant correlation with male and also with Age. Mean of third ventricle sylvian fissure distance index was 0.41±0.67 cm, 0.42±0.65 cm in male and 0.39±0.06 cm in female respectively. Mean of third ventricle ratio was 0.03±0.09 cm, 0.03±0.09 cm in male and 0.02±0.09 in female respectively. The value were slightly higher in male. ConclusionThe third ventricle width in CT in this study was 0.33±0.09 cm. CT was very useful to determine the upper limits of normal value and its variation with age.

scholarly journals Longterm Antiepileptic Therapy and Bone Health: Implications for Patients with Brain Tumors

2021 ◽  
Vol 49 (1, 2, 3) ◽  
pp. 23
Author(s):  
Admir Mehičević ◽  
Nevena Mahmutbegović ◽  
Ibrahim Omerhodžić ◽  
Enra Mehmedika Suljić
Keyword(s):  
Vitamin D ◽  
Brain Tumors ◽  
Bone Health ◽  
Monotherapy Group ◽  
Z Score ◽  
Mineral Density ◽  
Cross Sectional ◽  
Antiepileptic Agents ◽  
T Score ◽  
Significant Difference

<p><strong>Objective. </strong>The objective of our study was to investigate the effects of carbamazepine (CBZ) and lamotrigine (LTG) treatment on bone metabolism in epileptic patients.</p><p><strong>Patients and Methods. </strong>A cross-sectional study was performed on normal controls (N=30) and 100 patients with symptomatic epilepsy caused by a primary brain tumor, divided into two groups according to the treatment: LTG monotherapy group (N=50) and CBZ monotherapy group (N=50). For each participant serum levels of 25-OHD and osteocalcin (OCLN) were measured, and bone mineral density (BMD) was evaluated by the dual-energy X-ray absorptiometry method.</p><p><strong>Results</strong>. There was no statistically significant difference in the average values of vitamin D in serum between the CBZ and LTG groups (Vitamin D CBZ 17.03±}12.86 vs. Vitamin D LTG 17.97±}9.15; F=0.171, P=0.680). There was no statistically significant difference in the average values of OCLN between the CBZ and LTG groups (OCLN CBZ 26.06±}10.87 vs. OCLN LTG 27.87±}28.45; F=0.171, P=0.674). The BMD value was lower in both groups using antiepileptic agents compared to the controls, but when comparing the CBZ group to the LTG group, a statistically significant difference was only observed for the Z score (T-score CBZ: 0.08±} 1.38 vs. T-score LTG: 0.37±} 1.02; F=1.495, P=0.224; Z score CBZ: -0.05±}1.17 vs. Z. Score CBZ: 0.38±}0.96; F=4.069, P=0.046) (Table 3).</p><strong>Conclusion</strong>. The choice of antiepileptic agents for treating seizures in patients with brain tumors should be carefully evaluated in relation to their impact on bone health. These patients could benefit from supplementation and regular measurement of biochemical markers of bone turnover and BMD.

Bone Mineral Density Assessment by DXA vs. QCT in Postmenopausal Females with Central Obesity

2020 ◽  
Vol 13 (2) ◽  
pp. 153-161
Author(s):  
Lejla Milisic ◽  
Sandra Vegar-Zubovic ◽  
Amina Valjevac ◽  
Suada Hasanovic-Vučković
Keyword(s):  
Bone Mineral Density ◽  
Lumbar Spine ◽  
Bone Mineral ◽  
Proximal Femur ◽  
Central Obesity ◽  
Quantitative Computed Tomography ◽  
Normal Weight ◽  
Mineral Density ◽  
Cross Sectional ◽  
T Score

Objectives: Although Dual-energy X-ray Absorptiometry (DXA) is gold standard for osteoporosis diagnosis, several reports have shown discordant T-score values measured by Quantitative Computed Tomography (QCT) and DXA especially in obese subjects, but it is still not clear whether BMD measurement by two modalities is affected by overall obesity or central obesity in postmenopausal females. Therefore, the aims of this study were to compare BMD and T-scores by DXA and QCT and to evaluate whether these two osteoporosis assessment modalities yield different T-score values in postmenopausal females with obesity and central obesity. Methods: This cross-sectional study enrolled 44 postmenopausal females, referred for osteoporosis screening. Anthropometric indices (BMI-body mass index, WC-waist circumference and ICOindex of central obesity) were measured and females underwent an assessment of bone mineral density by DXA and QCT. Results: Lumbar Spine (LS) T-score values were observed to be significantly lower by DXA compared to qCT in females with BMI >25 kg/m2, (-1.9±1.5 vs. -2.3±1.2; p=0.039), in females with WC>88 cm(-1.9±1.5 vs. -2.4±1.2; p=0.008) and in females with ICO>0.5(-1.96±1.4 vs. -2.5±1.2; p=0.004). However, in normal-weight females and in those without central obesity, LS T-scores by DXA were not different than qCT. DXA at lumbar spine and proximal femur revealed osteoporosis in 47.7% and 11.4% respectively, while QCT detected osteoporosis in 61.4% of females (p<0.001). Measures of central obesity; ICO and WC were not associated with QCT bone mineral density (BMD) (r=0.14 and r=0.21, respectively), but were positively associated with both DXALS BMD (r=0.29 and r=0.31; p<0.05) and DXA proximal femur BMD (r=0.41 and r=0.44; p<0.01). Conclusion: Our results suggest that obesity is associated with lower T-scores by DXA compared to QCT. Caution is needed when assessing osteoporosis status in obese postmenopausal females. However, further studies with larger sample size are needed to confirm the findings.

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