Computed tomography values of lumbar spine in diagnosing osteoporosis: A meta-analysis

doi:10.3969/j.issn.1004-583X.2022.11.002

Abstract

Abstract: Objective To assess the efficacy of computed tomography (CT) values of lumbar spine in diagnosing osteoporosis (OP) by meta-analysis. Methods PubMed, Cochrane Library, Web of Science, CNKI, Wanfang and VIP Data (from the date of each database established to December, 2021) were searched for the studies regarding diagnostic accuracy of CT values of lumbar spine for OP, and the general information and the fourfold table data were extracted. The Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) was used to evaluate the risk of bias of the included studies. Meta-analysis was performed using Review Manager 5.4 and Meta-Disc 1.4. Results According to the vertebral bodies size, the eligible 13 studies were assigned to 6 groups of L1, L2, L3, L4, L5, and the L1-L4 mean Hounsfield units (HU) values. Since only one set of data was included for L5 and the L1-L4 mean HU values, no effect size combination was performed. The pooled sensitivity, pooled specificity, and areas under curve (AUC) of summary receiver operating characteristic (SROC) for L1 were 0.75 (95% $C I$ : 0.72-0.77), 0.72 (95% $C I$ : 0.70-0.73), and 0.8126 respectively; these values for L2 were 0.73 (95% $C I$ : 0.70-0.77), 0.75 (95% $C I$ : 0.73-0.77), 0.8010, respectively; and these for L3 were 0.78(95% $C I$ : 0.75-0.81), 0.72(95% $C I$ : 0.70-0.74), 0.7935, respectively. The pooled sensitivity and pooled specificity for L4 were 0.76 (95% $C I$ : 0.73-0.79) and 0.73(95% $C I$ : 0.70-0.75), respectively. Conclusion CT value of lumbar spine has certain significance in screening OP in different populations, however, its diagnostic ability is poor, the OP diagnosis should be analyzed comprehensively combined with other inspection results.

Key words: osteoporosis, CT values, diagnosis, meta analysis

CLC Number:

R681

Chen Jie, Chen Shu, Yin Yufeng, Chang Xin, Wu Jian. Computed tomography values of lumbar spine in diagnosing osteoporosis: A meta-analysis[J]. Clinical Focus, 2022, 37(11): 970-976.

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URL: https://huicui.hebmu.edu.cn/EN/10.3969/j.issn.1004-583X.2022.11.002

https://huicui.hebmu.edu.cn/EN/Y2022/V37/I11/970

Figures/Tables 9

研究	国家	CT值诊断阈值(HU)	年龄(岁)	样本量	TP	FP	FN	TN
Pickhardt 2013^[4]	美国	L1=135	59.2±12.5	2 040	348	389	113	1 190
Pickhardt 2013^[4]	美国	L2=155	59.2±12.5	2 048	341	388	130	1 189
Pickhardt 2013^[4]	美国	L3=150	59.2±12.5	2 046	356	437	114	1 139
Pickhardt 2013^[4]	美国	L4=145	59.2±12.5	2 021	354	423	114	1 130
Pickhardt 2013^[4]	美国	L5=150	59.2±12.5	1 943	327	387	119	1 110
Jameshouran 2020^[9]	伊朗	L1=160	48.80±14.11	92	29	8	2	53
黄伟刚2021^[10]	中国	L2=72.25	76.45±10.88	95	28	23	8	36
王志忠2021^[11]	中国	L1=113.5	61.1±12.1	95	23	8	15	49
Chia 2021^[12]	马来西亚	L1=149	≥50	50	20	0	5	25
Li 2018^[13]	中国	L1-L5的平均值=136	67	109	56	13	6	34
Pickhardt 2016^[14]	美国	L1=139	62.0±13.1	157	30	51	3	73
Cansu 2020^[15]	土耳其	L3=122	57.6±14.8	111	14	36	4	61
Lee 2015^[16]	韩国	L1=136.15	73.2±11.5	292	161	36	29	66
Lee 2015^[16]	韩国	L2=101.17	73.2±11.5	292	143	23	47	79
Lee 2015^[16]	韩国	L3=105.49	73.2±11.5	292	158	28	32	74
Lee 2015^[16]	韩国	L4=101.92	73.2±11.5	292	147	29	43	73
Cohen 2021^[17]	中东	L1=121	64±12	246	49	70	17	110
Jain 2020^[18]	美国	L1=135	66.4±9.08	313	24	112	10	167
Alacreu 2017^[19]	欧洲	L1=116	62.4±12.38	320	63	84	43	130
Buckens 2015^[20]	荷兰	L1=99/T12=104	57.9±15.2	302	51	46	31	174

测量的椎体	敏感度 (95% $C I$ )	特异度 (95% $C I$ )	PLR (95% $C I$ )	NLR (95% $C I$ )	DOR (95% $C I$ )	SROC曲线下面积(AUC)
L1	0.75(0.72-0.77)	0.72(0.70-0.73)	2.54(2.00-3.23)	0.36(0.27-0.48)	7.87(4.77-12.99)	0.8126
L2	0.73(0.70-0.77)	0.75(0.73-0.77)	2.76(2.17-3.51)	0.35(0.31-0.40)	8.17(6.63-10.08)	0.8010
L3	0.78(0.75-0.81)	0.72(0.70-0.74)	2.68(2.34-3.08)	0.30(0.22-0.39)	8.93(6.48-12.31)	0.7935
L4	0.76(0.73-0.79)	0.73(0.70-0.75)	2.77(2.53-3.04)	0.33(0.29-0.38)	8.34(6.7-10.39)	-

测量的椎体	敏感度 (95% $C I$ )	特异度 (95% $C I$ )	PLR (95% $C I$ )	NLR (95% $C I$ )	DOR (95% $C I$ )	SROC曲线下面积(AUC)
L1	0.75(0.72-0.77)	0.72(0.70-0.73)	2.54(2.00-3.23)	0.36(0.27-0.48)	7.87(4.77-12.99)	0.8126
L2	0.73(0.70-0.77)	0.75(0.73-0.77)	2.76(2.17-3.51)	0.35(0.31-0.40)	8.17(6.63-10.08)	0.8010
L3	0.78(0.75-0.81)	0.72(0.70-0.74)	2.68(2.34-3.08)	0.30(0.22-0.39)	8.93(6.48-12.31)	0.7935
L4	0.76(0.73-0.79)	0.73(0.70-0.75)	2.77(2.53-3.04)	0.33(0.29-0.38)	8.34(6.7-10.39)	-

年龄	纳入研究数量	灵敏度 (95% $C I$ )	特异度 (95% $C I$ )	PLR (95% $C I$ )	NLR (95% $C I$ )	SROC曲线下面积(AUC)
>60岁	6	0.75(0.71-0.79)	0.62(0.59-0.65)	2.02(1.67-2.44)	0.40(0.27-0.59)	0.7502
≤60岁	3	0.75(0.71-0.78)	0.76(0.74-0.78)	3.48(2.53-4.77)	0.33(0.20-0.53)	0.8701
未知	1	-	-	-	-	-

年龄	纳入研究数量	灵敏度 (95% $C I$ )	特异度 (95% $C I$ )	PLR (95% $C I$ )	NLR (95% $C I$ )	SROC曲线下面积(AUC)
>60岁	6	0.75(0.71-0.79)	0.62(0.59-0.65)	2.02(1.67-2.44)	0.40(0.27-0.59)	0.7502
≤60岁	3	0.75(0.71-0.78)	0.76(0.74-0.78)	3.48(2.53-4.77)	0.33(0.20-0.53)	0.8701
未知	1	-	-	-	-	-

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