骨超声衰减与双能X线吸收法测量骨密度的相关性研究

目的： 探讨跟骨宽带超声衰减诊断骨质疏松的临床价值。方法： 对一组５３ 例绝经期老年女性用超声衰减成像扫描仪测量左跟骨宽带超声衰减 （ＢＵＡ）, 并用双能Ｘ 线吸收法 （ＤＥＸＡ） 测量其腰椎Ｌ２－Ｌ４ 骨密度 （ＢＭ ＤＬ２－Ｌ４） 及右髋骨密度 （ＢＭ ＤＨ）, 将上述两种方法所测得的参数进行相关分析。结果： 左跟骨 ＢＵＡ 与腰椎ＢＭ Ｄ 呈中度相关 （ｒ＝ ０．６６１, Ｐ＜ ０．０００１）, 左跟骨ＢＵＡ 与右髋ＢＭ Ｄ 呈中度相关 （ｒ＝ ０．６１８, Ｐ＜ ０．０００１）, 左跟骨ＢＵＡ 与腰椎ＢＭ Ｄ、右髋ＢＭ Ｄ 诊断骨质疏松齐同率为８６．８％ 。结论： 跟骨ＢＵＡ 是评价骨密度的有效指标, 超声衰减成像技术是临床诊断骨质疏松的又一实用的新方法。     

双能X线吸收仪测定骨密度对骨质疏松症的诊断价值

目的:应用双能X线吸收仪(DEXA)测定腰椎L2～4前后位(anterior鄄post,A鄄P正位)和侧位的骨密度(BMD),以界定L2～4前后位和侧位男、女患者骨质疏松症(OP)的诊断临界值。方法:测定2115例患者L2～4的BMD,其中前后位1018例,侧位1097例。以T值≤-2.0s和≤-2.5s为诊断标准进行OP检出率分析。结果:按T值≤-2.0s、≤-2.5s计算,其中女性L2～4前后位的OP检出率分别为32.5%和14.5%,侧位分别为59.0%和33.4%;男性L2～4的前后位OP检出率分别为17.6%和6.4%,侧位分别为45.9%和17.8%。无论男女,以T值≤-2.0s为标准时,L2～4前后位与侧位的OP检出率差异显著(P<0.01)。L2～4前后位以T值≤-2.0s为标准的OP检出率和侧位以T值≤-2.5s为标准的OP检出率一致(P>0.05)。结论:男、女性L2～4前后位BMD测定可参考以T值≤-2.0s作为OP的诊断标准,侧位可参考以T值≤-2.5s作为诊断标准。     

双能X线骨密度检测对乳腺癌术后骨质疏松症的诊断价值

目的:探讨分析双能X线骨密度检测应用于乳腺癌手术后骨质疏松患者诊断中的临床应用价值.方法:将2018年9月至2020年6月作为研究时段,在该时段对我院接受乳腺癌手术的女性患者进行资料分析,并将其中符合实验要求的71名乳腺癌术后骨质疏松症患者作为研究对象.按要求对所有患者进行检查,应用双能X线骨密度检测方法,对骨量减少状...     

2型糖尿病患者双能X线骨密度检测分析

目的了解2型糖尿病患者骨密度（BMD）变化情况，骨质疏松（OP）检出率及相关影响因素。方法采用以色列DIREX公司生产的Dexa Scan DX-10-P-DXA型双能X线骨密度诊断，测定60例门诊及住院的糖尿病人非优势侧桡骨骨密度，以46例非糖尿病人为对照，结果进行统计学分析。结果2型糖尿病患者骨密度显著低于正常对照组（P〈0．05）；糖尿病组骨质疏松症发生率明显高于对照组；骨密度与患者年龄、病程、绝经年限呈显著负相关。结论骨质疏松症也作为糖尿病的慢性并发症，抗骨质疏松治疗和控制血糖同样重要。     

下颌骨骨密度的测量方法

骨密度的测量方法不断更新，但由于颌骨形态的特殊性及周围解剖结构的复杂性，限制了许多测量方法的应用。目前对颌骨密度的测量仍处于探索阶段，许多测量方法还不是很完善和成熟。本文介绍几种下颌骨骨密度测量常用的方法，并对下颌骨骨密度测量方法及其进展做一综述。     

上海地区2591例双能X线骨密度测量分析

目的分析骨密度(BMD)及骨质疏松(OP)患病变化规律。方法采用双能X线骨密度仪检测上海地区2591例桡骨远端1/3BMD,年龄范围20～80岁。按5岁一个年龄组进行统计分析。结果男、女BMD峰值均分布在35～39岁年龄组。BMD随年龄增加逐渐下降,同龄男性BMD大于女性。OP患病率随年龄增加而上升。结论OP常见发病年龄在中年之后,呈进行性病变,在老年人更常见。     

双能X线骨密度仪与定量CT测量骨密度的比较

骨质疏松必须有症状、体征、实验室检查(骨代谢生化和激素指标等)，X线片等方法的帮助，特异的定量的诊断骨质疏松的手段是骨密度测量，没有骨密度的支持是不能诊断骨质疏松。有创的骨组织形态计量法的手段难于在临床上推广，目前广泛应用的是各种无创性骨密度测量手段。故而临床中骨密度的测定目前主要是双能X线骨密度仪(dual-X-ray absorptiometry，DXA)与定量CT，但DCA与定量CT测量骨密度的争论由来已久。文章拟从两者的测量方式、原理及临床运用中遇到的问题作一综述。     

双能X线骨密度仪椎体骨密度测定骨质疏松症临床价值分析

目的:对骨质疏松症应用双能X线骨密度仪测定锥体骨密度的临床疗效展开分析。方法:选择我院2018年11月-2019年期间收治的80例骨质疏松患者作为研究对象,对所有患者均实施双能X线骨密度仪,测定不同年龄阶段椎体骨质疏松的情况。结果:不同年龄阶段骨质量测定的均值存在差异。根据骨密度的测定将其分为两个标准,骨密度≤x-2.0SD,骨密度≤x-2.5SD。经测定发现,所有患者的骨密度均不足x-2.0SD,其中65例骨密度不足。随着年龄的增长,骨质量均差的值越小。结论:对骨质疏松症应用双能X线骨密度仪测定锥体骨密度能够起到较高的临床应用价值,为临床治疗提供详细的数据,诊断价值较高。     

老年腰椎骨松质QCT值与双能X线骨密度的相关性分析

目的:探讨定量CT(QCT)与双能X线(DXA)测定老年患者腰椎骨密度值(BMD)的关系,评价用QCT测定来诊断骨质疏松的效果,为临床诊断骨质疏松症提供一种手段。方法:老年患者86例,分别对腰椎进行DXA的BMD测定及同层面腰椎骨松质QCT值测定,统计QCT及T值并与DXA测定的BMD值进行相关性分析。结果:腰椎骨松质的QCT及T值均与DXA测定的BMD呈显著正相关(r1=0.913,r2=0.817,均P<0.05)。结论:可通过QCT测定腰椎骨松质的骨密度,对骨质疏松症进行诊断。     

双能X线骨密度仪在15cm水深中测量骨密度的准确性

目的：探讨双能X线骨密度仪(dual energy X-ray absorptiometry，DXA)测量骨密度的准确性。方法：用DXA(前后位扫描)测量5具浸泡在15cm水深中的猪腰段脊柱，共计20例椎骨，计算测量的结果与灰重及灰重密度相关性。结果：骨矿含量与灰重呈显著正相关性(r=0．95，P&;lt;0．01)，而骨密度与灰重无明显相关性(r=0．41，P&;gt;0．05)。结论：DXA测量骨密度中骨矿含量较准确，而骨密度较差。     

青壮年甲状腺功能亢进患者的骨密度变化

目的:观察青壮年甲状腺功能亢进患者骨矿物质含量的变化.方法:采用双能X线吸收法测量84例青壮年甲亢患者(甲亢组)和84例与其年龄和性别匹配的正常健康者(对照组)的全身、正位腰椎(L2-4)和左侧股骨近端(包括股骨颈、大粗隆、髋关节)骨矿物质密度(BMD),并同时测量血清游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)水平.结果:在未接受治疗的84例青壮年甲亢患者中,女性有51.7%(30/58)存在骨矿含量异常,其中骨量减少和骨质疏松的发生率分别为36.2%(21/58)和15.5%(9/58);男性有46.2%(12/26)存在骨矿含量异常,其中骨量减少和骨质疏松的发生率分别为15.4%(4/26)和30.8%(8/26).甲亢组的全身、L2-4和左侧股骨近端BMD(除外男性L2～4,P＞0.05)低于对照组(P＜0.01).甲亢组病程、血清FT3、FT4含量与全身、L2～4、左侧股骨近端BMD值呈负相关(除外男性L2～4,P＞0.05).结论:甲亢是青壮年男、女性低骨量和骨质疏松的主要风险因素之一.     

Reproducibility of dual-energy X-ray absorptiometry in the upper extremities in stroke patients

Bone mineral loss after stroke in affected extremities can increase the prevalence of fractures that interrupt the rehabilitation programme and lower the level of activity. In stroke rehabilitation, precise bone mineral measurement is needed in order to assess the risk of fractures. We defined five regions-of-interest of the upper extremity (proximal humerus, distal forearm, distal radius, distal ulna and hand) consistently, so that the position was comfortable for hemiplegic patients to maintain during the measurement. The aim of this study was to determine whether our method using dual-energy X-ray absorptiometry is useful in hemiplegic patients. Ten normal subjects and 15 hemiplegic patients were studied. In normal subjects the reproducibility of our method was evaluated by repeated measurements of both the right and left sides. In hemiplegic patients the reproducibility was evaluated by repeated measurements of the affected side. The coefficient of variation (CV) values were obtained for BMD (0.7–1.7%) and BMC (0.7–2.3%) in normal subjects, and BMD (1.3–2.1%) and BMC (1.7–5.4%) in hemiplegic patients. The CV for the side-to-side BMD and BMC ratios in the normal subjects ranged from 11% to 2.2% and from 1.8% to 31%, respectively. Our study shows that the reproducibility of our method is sufficient for application to hemiplegic patients.     

双能X线吸收与定量CT对比评价北京地区中老年女性与年龄相关的骨丢失

目的 采用双能X线吸收(DXA)和定量CT(QCT)对比评价北京地区中老年女性骨密度与年龄相关的骨丢失。方法 收集北京地区接受腰椎正位及髋部DXA检查(面积骨密度测量)的社区女性10 472名,接受腰椎QCT检查(体积骨密度测量)的女性562名。将接受两种检查的受检者分别按每10岁年龄段分组。计算各组别的平均骨密度,并计算峰值骨密度各组别的骨丢失率,分析骨密度与年龄间的相关性。结果 DXA测量北京地区女性腰椎、股骨颈及全髋部的峰值骨密度均在30~39岁年龄组,40岁以后各部位骨密度开始不同程度减低,至80~94岁组腰椎、股骨颈、全髋部累计骨丢失率分别为21.7%、31.4%和29.5%;QCT测量腰椎松质骨的峰值骨密度在20~29岁组,至80~97岁组累计骨丢失率达58.2%。累计骨丢失率从高到低依次为腰椎松质骨 >股骨颈 >全髋部 >腰椎正位。结论 腰椎QCT可较DXA更早、更准确地显示中老年女性的骨丢失情况,对增龄性骨丢失更敏感。     

广东湛江地区老年人骨密度及骨质疏松患病率的初步调查

目的探讨湛江地区老年人骨密度（BMD）现状,为广东粤西沿海地区老年人骨质疏松症的防治提供科学依据。方法①采用美国Hologic QDR 4500A型双能X线骨密度仪对480例老年人的腰椎及髋部进行测量及分析。②按年龄、性别输入数据,以5岁为1个年龄组,分别计算骨密度。结果①60、70、80岁男性第2～4腰椎BMD分别为0.932、0.870、0.739,女性分别为0.831、0.707、0.647。②60、70、80岁男性Neck和Ward’s区BMD分别为0.752和0.683、0.734和0.650、0.671和0.593;女性分别为0.724和0.650、0.617和0.568、0.556和0.482。③60、70、80岁骨质疏松患病率男性为15.1%、28.9%和25.0%,女性为24.0%、47.5%和62.5%,女性骨质疏松患病率高于男性,差异有统计学意义（P〈0.05）。结论湛江地区老年人随着年龄的增加,男、女性腰椎和髋骨的骨密度逐渐下降。骨质疏松患病率随年龄增加而上升,同龄女性组骨质疏松患病率高于男性组。     

Comparison of phalangeal ultrasound and dual energy X-ray absorptiometry in healthy male and female adolescents

The aims of this study were to determine if there is a correlation between dual energy X-ray absorptiometry (DXA) and phalangeal quantitative ultrasound (QUS) in identifying children and adolescents with low bone density, and to assess if body size influences the results of the two techniques to the same degree. Measurements were performed in 67 girls and 83 boys aged 14 to 19 y using DBM Sonic 1200 (IGEA, Carpi, Italy) and the DXA equipment (LUNAR Radiation Corp., Madison, WI, USA). Twelve adolescents (eight males and four females) reported a past history of nonosteoporotic fractures. Lumbar spine bone mineral density (LS BMD), total body bone mineral density (TB BMD) and total body bone mineral content (TB BMC) correlated positively with age, height, BMI and weight, in both genders. Amplitude-dependent speed of sound (Ad-SOS) was positively correlated with age, height and Tanner stages in both genders and negatively correlated with BMI in females. TB BMD, TB BMC and LS BMD positively correlated with Ad-SOS only in males. In females, there were no significant correlations between Ad-SOS, TB BMD, TB BMC and LS BMD measurements. Twelve teenagers with previous fractures (high impact fractures) were found to have lower DXA and QUS values than age-matched teenagers without fractures but the statistical significance was found only in relation to TB BMD values (p = 0.02). In conclusion, we obtained results similar to those that have been reported by other authors using different QUS techniques. Furthermore, the Ad-SOS measurements taken at the distal metaphysis of the proximal phalanges correlate poorly with LS BMD and TB BMD measured by DXA in growing subjects. (E-mail: zhalaba@poczta.onet.pl)     

青壮年甲状腺功能亢进患者的骨代谢特征

目的：通过对初发的青壮年甲状腺功能亢进症（甲亢）患者的骨密度（BMD）的测定,研究甲亢患者骨代谢的特征。方法采用双能X线吸收法对我院369例初发未经治疗的青壮年甲亢患者组和148名健康对照组进行腰椎L2-4,股骨近端的BMD检测,同时测定甲状腺功能、AKP、PTH、CT、24 h尿钙、血钙等。结果比较甲亢组与健康对照组的FT3、FT4和TSH差异有统计学意义（P0.05）;甲亢骨量正常组24 h尿钙与对照组比较差异无统计学意义（P〉0.05）,而甲亢骨量异常组24 h尿钙与对照组比较有显著性差异（P〈0.05）;甲亢患者BMD与血清FT3、FT4呈负相关,与TSH呈正相关。结论通过甲状腺功能、骨密度及骨代谢指标的研究分析,发现甲亢将导致青壮年骨量减少和骨质疏松,因此在治疗甲亢时,不应忽略对骨质疏松的预防。     

Correlation of quantitative heel ultrasonography with central dual-energy X-ray absorptiometric bone mineral density in postmenopausal women.

OBJECTIVES: In this study, we sought the proper cutoff level for quantitative ultrasonography (QUS) of the heel in identifying bone mineral density (BMD) categories as determined by dual-energy x-ray absorptiometry (DXA) in postmenopausal women. METHODS: With the use of DXA, BMD categories of the lumbar spine and different areas of the left femur of 420 healthy women according to World Health Organization definitions were determined. Quantitative ultrasonography of the heel was also performed in each subject. Receiver operating characteristic curves were plotted, and sensitivity and specificity of QUS to diagnose osteoporosis were examined at different points to identify the best cutoff level. The diagnostic agreement between the two techniques in identifying osteoporosis was assessed with kappa scores. RESULTS: The kappa scores were 0.31 for the lumbar region and 0.5 for the femoral neck region. On the receiver operating characteristic study, a score of -1 was found to be the appropriate cutoff point for QUS studies, in which the sensitivity of QUS to diagnose BMD osteoporosis varied between 78% and 87.5% depending on the site of the DXA study. With the proposed cutoff point (-1), sensitivity and specificity of QUS in detecting osteoporosis at the lumbar spine were 83.9% and 51%, respectively, and at the femoral neck were 84% and 50%, respectively. CONCLUSIONS: Insufficient agreement between QUS and DXA led to uncertainty on expected BMD in people tested by QUS. The proposed cutoff value could achieve higher sensitivity but only by accepting higher rates of false-positive results.     

支气管哮喘患者腰椎和股骨近端骨密度测量

目的 观察接受糖皮质激素（ＧＣ）治疗的支气管哮喘患者骨矿物质密度的变化。方法采用双能Ｘ线骨密度仪（ＤＥＸＡ）测量２６例接受ＧＣ治疗的支气管哮喘患者和年龄、性别匹配的２６例正常健康者的腰椎２～４（Ｌ_（２～４））和右侧近端股骨（股骨颈、大转子和Ｗａｒｄ’ｓ三角区）的骨密度（ＢＭＤ）。结果接受 ＧＣ治疗支气管哮喘患者 Ｌ_（２～４）、右侧股骨近端的 ＢＭＤ测量值（ｇ／Ｃｍ~２） 明显低于年龄和性别匹配的正常健康者,且与ＧＣ用药时间呈显著负相关。结论接受ＧＣ治疗支气管哮喘患者存在明显的骨质丢失,并与ＧＣ用药时间密切相关。     

Predicting subchondral bone stiffness using a depth-specific CT topographic mapping technique in normal and osteoarthritic proximal tibiae

Background

Subchondral bone stiffness is thought to be involved in osteoarthritis pathogenesis. Our objective was to determine if a CT imaging technique, which measures density in relation to depth from the subchondral surface, could predict the stiffness of proximal tibial subchondral bone. A second objective was to determine whether cartilage degeneration (an indicator of osteoarthritis) affected predictions.

Methods

Thirteen proximal tibial compartments (4 medial, 9 lateral) from 10 male donors (age: mean 73.2, SD 10.6 years) were scanned using quantitative CT. We assessed average subchondral bone mineral density across different depths (0–2.5, 0–5, 0–10 mm) and layers (2.5–5, 5–10 mm) measured relative to the subchondral surface. We classified cartilage status as normal or degenerated using the International Cartilage Repair Society system. We performed macro indentation testing directly at the subchondral surface, and related stiffness to density measures using power-law regression models adjusted for side, age and cartilage status. We tested the coincidence of normal and degenerated regression models using F test statistics.

Findings

Density measures nearest the subchondral bone surface (0–2.5 mm) were most effective at predicting subchondral bone stiffness (r² = 0.67, p < 0.001). The predictive ability of depth-specific density measures decreased when density was averaged across larger depths or layers deep to the subchondral surface. Cartilage status did not affect model predictions.

Interpretation

Depth-specific density measures have potential use as in vivo imaging tools for characterizing subchondral bone density and estimating stiffness. This information could help explain the role of subchondral bone in osteoarthritis pathogenesis.