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Quantitative CT Reference Values for Vertebral Trabecular Bone Density in Children and Young Adults¹

¹ From the Department of Radiology (V.G., F.J.P., P.P.C., D.C.L.), Department of Pediatrics (F.J.D.), and Division of Orthopaedic Surgery (V.G., T.A.L.W.), Childrens Hospital Los Angeles, 4650 Sunset Blvd, MS 81, Los Angeles, CA 90027. Received January 30, 2008; revision requested April 5; revision received April 23; accepted May 30; final version accepted June 16. Supported by National Institutes of Health grants N01-HD0333, 1R01 AR-052744, 2R01 EB000298, 1R21 AR51564, R01 AR41853, and 1R01 LM06270; Department of the Army grant DAMD17-01-1-0817; the Gerber Foundation; and GlaxoSmithKline. Address correspondence to V.G. (e-mail: vgilsanz{at}chla.usc.edu).

Purpose: To determine normative reference values for vertebral trabecular bone density (TBD) obtained by using quantitative computed tomography (CT) in healthy white children, teenagers, and young adults of both sexes.

Materials and Methods: The data presented in this HIPAA-compliant study are a compilation of data from multiple investigations on the determinants of bone acquisition in healthy children conducted at this institution from 1992 to 2006. The institutional review board for clinical investigations approved the protocols for each of these studies, and written informed consent was provided by all parents and/or participants. Quantitative CT measurements of TBD (in milligrams per cubic centimeter) were obtained at the first, second, and third lumbar vertebrae in 1222 healthy white male and female subjects aged 5–21 years (mean age for male subjects, 15.1 years ± 3.6 [standard deviation]; range, 5.6–21.9 years; mean age for female subjects, 14.2 years ± 3.9; range, 5.7–21.6 years; mean age for both sexes, 14.6 years ± 3.8). Mean and standard deviations for TBD were determined for each age group in 1-year intervals, and Student t tests for unpaired data were performed to compare male subjects with female subjects.

Results: TBD increased equally during growth in male and female subjects. Although the percentage increase in TBD was similar for both sexes (23.7% [57 of 241] for male subjects, 22.2% [54 of 243] for female subjects), the rise began and reached peak values at an earlier age in female subjects; increases in TBD occurred from 10–15 years of age in female subjects, whereas in male subjects, these increases were not observed until age 12 years and were completed at 17 years.

Conclusion: This study provides reference standards for quantitative CT bone measurements in children and young adults, which may aid in the diagnosis, prevention, and treatment of pediatric metabolic bone disorders.

© RSNA, 2008