通过常规CT测量系统性骨损失与增加疼痛,姿势失补偿和多发性骨髓瘤的存活率有关
Julian Kylies1, Katja Weisel2, Tobias M Ballhause2
1University Medical Center Hamburg-Eppendorf, Hamburg, Germany. j.kylies@uke.de.
概括
多发性骨髓瘤患者经历了显著的脊椎骨损失,通过CT扫描的Hounsfield单位 (HU) 减少来衡量. 35%或更多的下降表明疼痛更高,功能下降,以及更差的生存结果.
科学领域:
- 放射学 放射学是一门学科.
- 在瘤学瘤学.
- 骨的新陈代谢 骨的新陈代谢
背景情况:
- 多发性髓瘤 (MM) 经常导致骨质损失.
- 脊椎骨损失,通过CT扫描的Hounsfield单位 (HU) 减少量化,具有未充分探索的临床意义.
- 对MM患者脊椎骨质量的纵向评估对于了解疾病进展和患者结果至关重要.
研究的目的:
- 用常规CT扫描来研究MM患者脊椎HU的纵向变化.
- 评估脊椎HU下降与疾病参数,姿势对齐,功能和生存的关联.
- 确定脊椎骨损失的临床相关值.
主要方法:
- 对79名MM患者进行了三次连续全身CT扫描的回顾性分析.
- 在L1-L4处评估脊椎HU值,并通过ROC分析确定≥35%的下降值.
- 关于疾病活性,类固醇使用,骨保护疗法,功能和营养状况的子组分析;评估与疼痛,姿势和生存的关联.
主要成果:
- 脊椎HU值随着时间的推移显著下降 (p < 0.0001).
- 较高的疾病活性和类固醇治疗加速了HU的下降,而骨质保护治疗减轻了它.
- 一个≥35%的HU下降值与疼痛增加,止痛药使用,姿势恶化和整体生存率降低相关 (p=0.04).
结论:
- 基于CT的HU测量允许纵向评估MM的脊椎骨质量.
- 一个≥35%的HU下降确定患者的风险疼痛,功能下降,和更差的预后.
- HU下降是MM疾病负担和活动的潜在标志物.
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