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.