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Densitometric and geometric measurement of the proximal femur in elderly women with and without osteoporotic vertebral fractures by volumetric quantitative multi-slice CT

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There is a lack of research on volumetric multi-slice CT (MSCT) application in hip densitometric assessment and geometric measures in elderly women with osteoporotic vertebral fractures. A total of 237 elderly women were divided into three groups based on BMD values of the lumbar spine (AP-SPINE) and/or the femoral neck (NECK) by dual energy X-ray absorptiometry (DXA): osteoporosis with (OP_FX, 53 cases) or without vertebral fracture (OP_NONFX, 94 cases), or normal BMD (CONTROL, 90 cases). Volumetric BMD of trabecular bone (TRAB), integral bone (INTGL) and cortical bone (CORT) with neck axis length (NAL) and minimum cross-section area (mCSA) measures of the left femoral neck were calculated, respectively, by using OsteoCAD software based on MSCT scans of the abdominal-pelvic region of all participants, then the index of femoral neck strength (FNSI) was estimated. The values of TRAB, CORT and INTGL of OP_FX were significantly lower than those of OP_NONFX, with the decrease in 6.8–21.8%, as well as being lower than those in CONTROL, whereas no significant differences in the values of AP-SPINE and NECK were found between OP_FX and OP_NONFX. No significant difference of the value of mCSA was found among these three groups. The NAL value of OP_NONFX was larger than that of CONTROL. FNSI of femoral neck in OP_FX (0.42 ± 0.15 g2/cm4) was significantly lower than OP_NONFX (0.50 ± 0.14 g2/cm4) (p < 0.05). vQCT measurement seemed to be more effective than DXA in evaluating hip densitometric changes and discriminating osteoporotic elderly subjects with fractured vertebrae from the non-fractured in a group of Chinese women.

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We would like to thank Professor Jing-xue Li in the Department of Radiology, General Hospital of Tianjin Medical University, China, for his suggestions on study design. We also acknowledge Dr. Didier Hans at the Center of Bone Diseases, Department of Bone and Joints, Lausanne University Hospital, Switzerland; Mr. William Badger in the Department of Imaging Sciences, University of Rochester Medical Center, USA, for providing important comments on this study.

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Correspondence to Sheng-yong Wu or Zhuo-li Zhang.

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Wu, Sy., Qi, J., Lu, Y. et al. Densitometric and geometric measurement of the proximal femur in elderly women with and without osteoporotic vertebral fractures by volumetric quantitative multi-slice CT. J Bone Miner Metab 28, 682–689 (2010).

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