臺灣博碩士論文加值系統

隨著人類壽命的延長與人口老化的社會結構，骨質疏鬆症已僅次於心血管疾病，成為全球第二大的重要流行病。世界衛生組織(WHO)於1994公佈成年人骨質疏鬆症的定義為『一種因骨量減少或骨密度降低而使骨骼微細結構發生破壞的疾病，惡化的結果將導致骨骼脆弱，並使骨折的危險性明顯增高』。骨質疏鬆症將可能導致各人體多部位發生骨折現象，而其中尤以脊椎體及髖部骨折最為嚴重。近來因人口高齡化，骨質疏鬆症急速增加。未來骨質疏鬆症盛行率及社會醫療資源之耗損恐將繼續攀升，需要政府及醫療人員共同協助，期望能夠達到早期發現健康族群預防之目的。
目前臨床標準骨質密度檢查為雙能X光吸收法。此檢查利用二維電腦化的掃瞄設備使用低劑量的放射線去檢測髖關節與脊椎的骨質密度。但二維的影像所提供的數據以及骨質密度百分比並無法代表骨實質鈣含量數值與密度，此誤差可能導致醫師針對骨質疏鬆症的病況與病程有所誤判，因此開發更準確之檢查方式為本研究之重點。
由於目前本院健康檢查之配套項目中包含腹部雙能量電腦斷層掃瞄，藉由寶石能譜成像模式進行此組腹部掃瞄影像的重組，可得到三維的脊椎影像與實質鈣含量數據。本研究將利用同一項檢查，不但獲取兩組包含腹部電腦斷層影像與三維脊椎骨影像資訊，亦可減少病人兩項檢查分別接受之輻射劑量風險。

With the extension of human life and social structure of population aging, osteoporosis is the second major worldwide epidemic disease which only inferior to cardiovascular disease. In 1994, World Health Organization (WHO) defines the adult osteoporosis "characterized by low bone mass, deterioration of bone tissue and disruption of bone architecture, compromised bone strength, and an increase in the risk of fracture". The decrease in the overall strength of the bone leads primarily to multi-site fracture and vertebral body (in the spine) fractures.
Dual-energy x-ray absorptiometry (DXA) is currently the criterion standard for the evaluation of BMD. The test use two-dimensional image for bone density calculation. However, two-dimensional image data may only provide the percentage of bone density but cannot represent the true value of the calcium content in bone region. Moreover, two-dimensional vertebrae images must consider the error from other organizations. This error information will decrease the diagnostic accuracy of physician. The goal of this study is to develop a more accurate way to evaluate bone density.
In this study, we will use gemstone spectral imaging system to restructure abdomen dual-energy computed tomography (DECT) scan image from health patient, consequently; we can obtain three-dimensional images and substance calcium content of spine. We may not only receive abdomen image for routine diagnosis but also acquire spine image for bone density calculation from single source DECT examination, which can reduce the exposure dose of radiation. Furthermore, CT spine image may also be used for the analysis of true calcium content within spine.

中文摘要-i
英文摘要-ii
第一章、緒論-1
1-1第一節 骨-1
1-2第二節 骨質疏鬆症-2
1-3第三節 雙能X光吸收法-3
1-4第四節人口老化對台灣社會的衝擊-4
1-5第五節 雙能電腦斷層能譜影像-5
1-6第六節研究目的與目標-9
第二章、研究方法-14
2-1第一節 收案方式-14
2-2第二節 電腦斷層-14
2-3第三節 校正假體-15
2-4第四節 影像分析-15
2-5第五節 CaHA濃度數值校正與DXA數值對照-16
2-6第六節 統計分析-16
第三章、研究結果-18
3-1第一節 病患資料-18
3-2第二節 校正假體-19
3-3第三節 各年齡層不同性別之CaHA濃度-20
3-4第四節 CaHA濃度與身高體重及身體質量指數BMI之關係-25
3-5第五節 CaHA濃度在不同感興趣區域ROI直徑下的關係-29
3-6第六節 GSI CaHA濃度值與DXA數值之比較-31
第四章、討論-32
第五章、結論-35
第六章、參考文獻-36

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