Abstract
OBJECTIVE: This study investigates the diagnostic significance of CT values of thoracic vertebral trabecular bone in diagnosing senile osteoporosis and assessing the risk of concomitant thoracic vertebral fractures. METHODS: A retrospective analysis was conducted on 124 elderly patients diagnosed with osteoporosis (osteoporosis group), 30 patients with osteopenia (osteopenia group), and 30 individuals with normal bone mineral density (normal group) at our hospital. All participants underwent low-dose chest CT and dual-energy bone densitometry. The osteoporosis group was further divided into a fracture subgroup (42 cases) and a non-fracture subgroup (82 cases) based on the presence of thoracic vertebral fractures. RESULTS: CT values of thoracic vertebral trabecular bone showed a positive correlation with bone mineral density T-scores (P < 0.05). Significant differences were observed in CT values and T-scores among the three groups (P < 0.05), with the following order: osteoporosis group < osteopenia group < normal group (P < 0.05). The fracture and non-fracture subgroups also exhibited significant differences in CT values and T-scores (P < 0.05). The 95% confidence interval upper limits for CT values in the fracture subgroup, non-fracture subgroup, and osteopenia group were 54.0 HU, 85.3 HU, and 112.2 HU, respectively. CONCLUSION: CT values of thoracic vertebral trabecular bone are closely associated with senile osteoporosis and hold significant diagnostic value for both osteoporosis and fracture risk assessment. A CT value < 85.3 HU may serve as a diagnostic threshold for osteoporosis, while a CT value < 54.0 HU indicates an increased risk of thoracic vertebral fractures.