Quantitative assessment of zonal trabecular volumetric bone mineral density in middle-aged and elderly women using quantitative computed tomography

BACKGROUND: To explore the feasibility of the 9 zonal trabecular volumetric bone mineral density (trabecular vBMD) method in the first lumbar vertebral body (L1) and to assess the zonal trabecular vBMD distribution of L1 in women aged 50–80 years. METHODS: A total of 578 women patients underwent a quantitative computed tomography (CT) scan of the L1 vertebra, and these patients were categorized into 3 age subgroups with 10-year intervals. L1 was segmented into 9 zones, based on which, L1 was then divided into 6 regions [i.e., vBMD-anterior (vBMD-A), vBMD-medial (vBMD-M), and vBMD-posterior (vBMD-P) from the ventral to the dorsal side, vBMD-upper (vBMD-U), vBMD-medial (vBMD-M'), and vBMD-lower (vBMD-L) from the head to the foot]. Independent samples t-test, intraclass correlation coefficient (ICC), and one-way analysis of variance (ANOVA) were used for statistical analyses. RESULTS: There were no significant differences of the 9 zonal vBMDs measured by the 2 analysts (P≥0.638), and ICCs were all greater than or equal to 0.990. There was significant difference of global vBMD among the 3 age groups (P<0.001), and so as to the 9 zonal vBMDs among the 3 age groups (P<0.001). Age was negatively correlated with global vBMD and the 9 zonal vBMDs (P<0.001). There were significant differences among vBMD-A, vBMD-M, and vBMD-P (P<0.001), and vBMD-A and vBMD-M were both lower than vBMD-P. There were significant differences among vBMD-U, vBMD-M', and vBMD-L (P<0.001), and vBMD-U and vBMD-L were both lower than vBMD-M'. CONCLUSIONS: The 9 zonal trabecular vBMD method of L1 is stable and feasible, and the 9 zonal trabecular vBMD method may quantitatively explain osteoporotic vertebral deformity from the perspective of vBMD in middle-aged and elderly women.