Quantitative CT analysis of the correlation between paravertebral muscle and bone mineral density
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摘要:
目的采用定量CT探讨骨密度与椎旁肌的增龄性改变及二者的相关性。 方法对2020年6~11月于我院行定量CT骨密度检查的患者进行回顾性分析，采用定量CT测量L3中部层面的椎旁后群肌（竖脊肌和多裂肌）的横截面积；采用星云医学影像后处理平台V9.0测量L4~5椎间隙的腰大肌（椎旁前肌群）的横截面积，分析椎旁肌与骨密度的随着年龄变化的规律和二者的相关性。 结果女性的椎旁后群肌的含量（横截面积）在40~60岁明显增多，而男性的随着年龄增长而减少，右侧腰大肌含量随着年龄的增长而降低，而左侧的腰大肌含量在男性40~60岁明显增多，女性40岁以下明显增多。男性的椎旁肌含量随着年龄增长大于女性，骨密度也随着年龄增长而降低，男性骨密度大于女性（男性r=-0.625，P < 0.001；女性r=-0.600，P < 0.001）。腰大肌、椎旁后群肌与骨密度均呈正相关，男性相关性高于女性，右侧高于左侧（男性右侧椎旁后群肌r=0.432，P=0.009；左侧椎旁后群肌r= 0.401，P=0.017；右侧腰大肌r=0.510，P=0.002；左侧腰大肌r=0.447，P=0.007；女性右侧椎旁后群肌r=0.319，P < 0.001；左侧椎旁后群肌r=0.276，P < 0.001；右侧腰大肌r=0.279，P < 0.001；左侧腰大肌r=0.220，P=0.004）。 结论椎旁肌随着年龄变化发生改变，男性椎旁肌的含量大于女性，骨密度与年龄呈负相关，腰大肌、椎旁后群肌与骨密度均呈正相关，男性的相关性高于女性，右侧高于左侧，男性的椎旁后群肌与骨密度的相关性低于腰大肌与骨密度的相关性，而女性的椎旁后群肌与骨密度的相关性高于腰大肌与骨密度的相关性。 Abstract:ObjectiveTo investigate the age-related changes of bone mineral density (BMD) and paravertebral muscle and their correlation by quantitative CT. MethodsThe patients who underwent QCT bone mineral density examination in our hospital from June to November 2020 were retrospectively analyzed. Quantitative CT was used to measure the cross-sectional area of the paravertebral posterior muscle groups (erector spinae and multifidus) at the central level of L3. The Philips Nebula Medical Image Postprocessing Platform V9.0 was used to measured the cross-sectional area of the psoas major (paraspinal anterior muscle group) in the L4-L5 intervertebral space. The change of paravertebral muscle and BMD with age and their correlation were analyzed. ResultsThe content of the paraspinal posterior muscle (cross-sectional area) grew considerably in women between the ages of 40 and 60, but declined with age in males, whereas the content of the right psoas major muscle decreased with age. The content of the left psoas major muscle increased significantly between the ages of 40 and 60 in men and under 40 in women. The paravertebral muscle content of males was greater than that of females with the increase of age, and the BMD also decreased with the increase of age. The BMD of males was greater than that of females(male r=-0.625, P= 0.000; female r=-0.600, P=0.000).The psoas major muscle and paravertebral posterior muscle group were positively correlated with BMD, the correlation was higher in male than in female, and the right was higher than the left. (Right paravertebral posterior muscle in male r=0.432, P=0.009;The left paravertebral posterior muscle r=0.401, P=0.017;Right psoas major r=0.510, P=0.002; left psoas major r=0.447, P=0.007;Right paravertebral posterior muscle in female r=0.319, P=0.000; The left paravertebral posterior muscle r=0.276, P=0.000; Right psoas major r=0.279, P=0.000; left psoas major r=0.220, P=0.004). ConclusionThe paraspinal muscle content in men is higher than in women. BMD is inversely proportional to age. BMD is favorably linked with the psoas major and posterior paraspinal muscles. The male-to-female correlation is greater than the female-to-female correlation. The right side of the building is higher than the left. Men's paraspinal group muscles have a lower correlation with BMD than women's psoas muscles, whereas women's paraspinal group muscles have a greater correlation with BMD than men's psoas muscles relevance. -
Key words:
- paravertebral muscle /
- psoas major /
- bone mineral density /
- quantitative CT
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图 1 各部位测量方法
A: QCT测量腰椎L1-L3的骨密度; B: L4~5椎体肌间隙的左右腰大肌的横截面积; C: L3椎体正中层面的右侧椎旁后群肌的肌肉面积; D: L3椎体正中层面的左侧椎旁后群肌的肌肉面积.
Figure 1. Measurement method of each part.
图 2 男女在各组之间的椎旁肌及骨密度的差异分布
A: 男女组的右侧椎旁后群肌与年龄的条形分布图; B: 男女组的左侧椎旁后群肌与年龄的条形分布图; C: 男女组的右侧腰大肌与年龄的条形分布图; D: 男女组的左侧腰大肌与年龄的条形分布图; E: 男女组的BMD与年龄的条形分布图.
Figure 2. The difference of paravertebral muscle and bone mineral density between male and female in each group.
表 1 年龄、单侧椎旁后群肌、腰大肌和骨密度的平均值及椎旁肌与BMD的相关性分析
Table 1. Age, mean value of unilateral paravertebral posterior muscle, psoas major muscle and bone mineral density, and correlation between paravertebral muscle and BMD were analyzed
变量 男（n=35） 女（n=169） 均数±标准差 r P 均数±标准差 r P 年龄（岁） 57.54±17.09 -0.625 0.000 62.89±14.45 -0.600 0.000 右椎(cm2) 20.73±3.94 0.432 0.009 15.89±4.02 0.319 0.000 左椎(cm2) 22.04±3.84 0.401 0.017 17.02±4.07 0.276 0.000 右腰(cm2) 11.99±2.81 0.510 0.002 7.61±1.66 0.279 0.000 左腰(cm2) 12.22±3.09 0.447 0.007 7.81±1.79 0.220 0.004 右椎：右侧L3椎旁后群肌的横截面积；左椎：左侧L3椎旁后群肌的横截面积；右腰：右侧L4~5腰大肌的横截面积；左腰：左侧L4~5腰大肌的横截面积. 
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表 2 研究对象按年龄分组的椎旁肌、腰大肌及骨密度的测量结果
Table 2. The paravertebral muscle, psoas major muscle and bone mineral density were measured by age group (Mean±SD)
变量 男（n=35） 女（n=169） ≤40岁（n=5） 41~60岁（n=16） ≥61岁（n=14） ≤40岁（n=13） 41~60岁（n=51） ≥61岁（n=105） 右椎(cm2） 22.28±2.96 21.72±3.84 19.04±3.95 16.17±2.83 17.15±3.22 15.25±4.36 左椎(cm2) 23.10±3.24 22.69±3.88 20.91±3.94 17.28±3.27 17.65±3.15 16.68±4.52 右腰(cm2) 13.97±1.65 12.71±2.97 10.46±2.23 8.69±1.66 7.78±1.74 7.39±1.57 左腰(cm2) 13.21±2.49 13.26±3.44 10.67±2.27 8.56±1.43 7.97±1.95 7.64±1.73 骨密度(mg/cm3) 163.06±39.94 115.46±29.64 85.00±41.82 137.16±49.44 108.50±38.45 66.32±30.07 右椎：右侧椎旁后群肌的横截面积，左椎：左侧椎旁后群肌的横截面积，右腰：右侧腰大肌的横截面积，左腰：左侧腰大肌的横截面积.
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表 3 不同性别的各年龄段间的椎旁肌、腰大肌与骨密度的相关性分析
Table 3. Correlation analysis of paravertebral muscle psoas major muscle and bone mineral density between different sexes and different ages
变量 男（n=35） 女（n=169） ≤40岁（n=5） 41~60岁（n=16） ≥61岁（n=14） ≤40岁（n=13） 41~60岁（n=51） ≥61岁（n=105） r P r P r P r P r P r P 右椎 0.576 0.309 0.397 0.128 0.234 0.421 0.477 0.100 0.331 0.018 0.239 0.014 左椎 0.502 0.389 0.354 0.178 0.323 0.259 0.338 0.258 0.227 0.109 0.291 0.003 右腰 -0.293 0.632 0.454 0.077 0.407 0.149 -0.025 0.935 0.276 0.050 0.206 0.035 左腰 0.232 0.708 0.386 0.140 0.396 0.162 0.141 0.646 0.249 0.078 0.128 0.192 右椎: 右侧椎旁后群肌的横截面积; 左椎: 左侧椎旁后群肌的横截面积; 右腰: 右侧腰大肌的横截面积; 左腰: 左侧腰大肌的横截面积.
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