Assessing Bone Mineral Density Following Acute XXXX : The Role of Computed Tomography Attenuation.

@entity1 @entity2249 @entity170 @entity79 @entity173 @entity130
OBJECTIVES: In older @entity1 , @entity79 ( @entity79 ) diminishes with age, increasing susceptibility to @entity2249 . Evidence has emerged that @entity1 who should have dual x-ray absorptiometry scans to evaluate their bone health are not doing so. Because computed tomography (CT) attenuation has now been correlated with @entity79 thresholds relating to @entity170 , virtually any existing CT scan that includes the L1 vertebra can be used to assess @entity79 . This study evaluates the utility of CT attenuation in characterizing @entity79 in @entity1 after @entity2249 . METHODS: The electronic medical records of adults who presented to a level I @entity130 center with @entity173 were evaluated for eligibility. Those with a CT scan of the abdomen or other CT scan with a complete view of the L1 vertebra were included. To measure attenuation, a region of interest was selected to include the body of the L1 vertebra in the axial plane and exclude the cortices and posterior venous complex. RESULTS: Of the 589 @entity1 reviewed, 217 met inclusion criteria; 112 were aged 18 to 64, while 105 were >= 65. Eight (7.1%) @entity1 in the younger cohort had a mean CT attenuation below the 110-HU threshold set for 90% specificity, whereas 31 (29.5%) @entity1 in the older cohort had a mean CT attenuation below this threshold. Using the 160-HU threshold set for 90% sensitivity, 39 (34.8%) @entity1 of the younger cohort and 74 (70%) @entity1 of the older cohort were osteoporotic; all differences in CT attenuation by age were strongly significant (P < .0001). CONCLUSIONS: A significantly larger proportion of older @entity1 with @entity173 had @entity170 , helping validate the utility of CT attenuation in this context. In addition, a large proportion of these @entity1 already had these images available, thus potentially helping limit cost and unnecessary medical investigations.
