Title Povezanost koštane gustoće slabinske kralježnice i masne infiltracije m. psoasa na CT abdomena
Title (english) Correlation between bone density of the lumbar spine and fatty infiltration of psoas muscle in abdominal CT
Author Matea Bolčić
Mentor Danijela Budimir Mršić (mentor)
Committee member Maja Marinović Guić (predsjednik povjerenstva)
Committee member Sanja Lovrić Kojundžić (član povjerenstva)
Committee member Danijela Budimir Mršić (član povjerenstva)
Granter University of Split (University Department of Health Studies) (Chair of Radiologic Technology) Split
Defense date and country 2022-07-13, Croatia
Scientific / art field, discipline and subdiscipline BIOMEDICINE AND HEALTHCARE Clinical Medical Sciences Radiology
Abstract Osteoporoza je bolest smanjene koštane gustoće i predstavlja veliki javnozdravstveni problem, koji najčešće zahvaća osobe starije životne dobi, više žene nego muškarce. Osim promjena na kostima, koje nastaju s dobi, prisutne su i promjene na mišićima, a manifestiraju se kao atrofija i masna infiltracija mišića. Zlatni standard u dijagnostici osteoporoze je denzitometrija, metoda koja koristi rendgenske zrake dviju energija, a dobiveni rezultati se uspoređuju s rezultatima mlade, zdrave populacije u standardnim devijacijama. U zadnjih nekoliko godine sveprisutna je ideja oportunističkog CT probira smanjene gustoće kostiju, koja je pokazala izvrsnu korelaciju s denzitometrijom. Uz to, CT se pokazao kao izvrsna metoda u dijagnostici masne infiltracije mišića, koja se prikazuje kao niže vrijednosti u Hounsfieldovim jedinicama (H.J.), a može prikazati promjene koje nastaju infiltracijom masti od samo 3%. Cilj ovog istraživanja je bio odrediti možebitnu povezanost koštane gustoće slabinske kralježnice i masne infiltracije m. psoasa majora na CT abdomena u osoba mlađe i srednje životne dobi u kojih ne očekujemo izražene degenerativne promjene. Također, istražili smo utječe li primjena jodnog kontrastnog sredstva na mjerenja denziteta kosti i mišića na postkontrastnim fazama CT snimanja. Retrospektivno su analizirani slikovni materijali 113 ispitanika u dobi od 18 do 49 godina, koji su podvrgnuti višefaznom protokolu CT abdomena i zdjelice od srpnja do prosinca 2021. godine u KBC Split. Na aksijalnim presjecima su kružnim ROI-em mjerene H.J. trabekularnog dijela trupa L4 kralješka, a konture oba m. psoasa su iscrtavane ručno i u nativnoj, arterijskoj i venskoj fazi te također izražene u H.J. Rezultati su pokazali značajnu povezanost smanjene gustoće kostiju i masne infiltracije m. psoas majora s dobi ispitanika, a utvrđena je međusobna pozitivna korelacija smanjene koštane gustoće i masne infiltracije mišića. Nisu pronađene značajne razlike između spola ispitanika, izuzev nativno viših vrijednosti denziteta trupa L4 kralješka u ženskih ispitanica. Primjena jodnog kontrastnog sredstva značajno je utjecala na mjerene vrijednosti oba parametra. Razlika između nativnih i postkontrastnih mjerenja koštane gustoće L4 kralješka je u prosjeku iznosila 20 H.J., a denziteta m. psoasa majora oko 6-8 H.J., s tim da su postkontrastne razlike u denzitetima m. psoasa bile neznačajno više kod žena nego kod muškaraca. Dobivenim rezultatima smo potvrdili početnu hipotezu i smatramo da oportunistički dobiveni podatci s CT snimanja za druge indikacije uistinu mogu dati vrijedne podatke, koji se mogu iskoristiti u svrhu dijagnosticiranja smanjene gustoće kostiju i masne infiltracije mišića.
Abstract (english) Osteoporosis is a disease of reduced bone density, and it represents a major public health problem that most commonly affects the elderly, more often women than men. In addition to the age-related bone changes, age-related changes in the muscles are also recognized, and they manifest as atrophy and fatty infiltration of the muscles. The gold standard for the osteoporosis diagnosis is a densitometry, method that uses X-rays of two energies, and compares the results with those of a young, healthy population in standard deviations. In recent years, the idea of opportunistic CT screening of reduced bone density has been broadly introduced, showing an excellent correlation with densitometry. In addition, CT has proven to be an excellent method for the diagnosis of muscle infiltration, which is presented as lower values of Hounsfield units (H.U.), confirming that CT can show changes resulting from fat infiltration of only 3%. The aim of this study was to determine the possible association between bone density of the lumbar spine and fatty infiltration of the psoas major muscle on the abdominal CT in young and middle-aged people in whom the obvious degenerative changes are not to expect. We also investigated whether the use of iodine contrast agent affected bone and muscle density measurements in the postcontrast phases of CT imaging. The imaging materials of 113 subjects aged 18 to 49, who underwent a multiphase CT protocol of the abdomen and pelvis from July to December 2021 at the Clinical Hospital Center Split, were retrospectively analyzed. On axial CT slices, H.J. was measured by drawing a circular ROI in the trabecular part of L4 vertebra, and the contours of both psoas muscles were drawn manually and were expressed in anaverage H.U. The results showed a significant age correlation of a decreased bone density and fatty infiltration of psoas muscle with age, and a positive correlation between reduced bone density and fatty infiltration of a muscle. No significant differences were found between the sexes of the subjects, except for higher values of L4 vertebral body density in female subjects on native scans. The application of iodine contrast agent significantly affected the measured values of both parameters. The difference between native and postcontrast measurements of L4 vertebral bone density averaged 20 H.U., and the density of m. psoas major was 6-8 H.U., with postcontrast differences in density of m. psoas being slightly higher in women than in men. The results confirmed the initial hypothesis and we believe that opportunistic CT imaging for other indications can indeed provide valuable data, which can be used to diagnose reduced bone density and fatty muscle infiltration.
Keywords
CT
kontrastno sredstvo
koštana gustoća
masna infiltracija
m. psoas major
Keywords (english)
bone density
contrast agent
CT
fatty infiltration
psoas muscle
Language croatian
URN:NBN urn:nbn:hr:176:256334
Study programme Title: Radiologic Technology (university/undergraduate) Study programme type: university Study level: undergraduate Academic / professional title: sveučilišni prvostupnik/prvostupnica (baccalaureus/baccalaurea) radiološke tehnologije (sveučilišni prvostupnik/prvostupnica (baccalaureus/baccalaurea) radiološke tehnologije)
Type of resource Text
File origin Born digital
Access conditions Open access
Terms of use
Created on 2022-07-14 06:52:13