测量腰椎、股骨近端骨密度中若干问题研究

时间:2020-10-07 14:50:19 药学毕业论文 我要投稿

测量腰椎、股骨近端骨密度中若干问题研究

[摘要] 目的 通过应用双能X线骨密度仪(DXA)测量腰椎和股骨骨密度(BMD)中几技术问题研究,指出在测量和分析结果时值得注意的几个问题。方法 比较同一选择标准束和薄型束扫描股骨近端结果的不同;对腰椎各椎体间T评分差>1 SD,不同分析方法的差别;列举1例患者比较股骨颈感兴趣区微小变化对诊断结果的影响。结果 对瘦体型患者薄型束扫描骨边缘比标准束完整,各部位BMD值有增加,在大粗隆部位二者T评分相差最大可超过3 SD;正常人相邻椎体间T评分差<SD,患者1 L3和L4相差2.2 SD,患者2 L2和L3相差1.3 SD,患者3 L2和L3相差1.5 SD,相邻椎体间差均>1 SD;股骨颈感兴趣区中心位置在X轴线上从124变为120微小移动,股骨颈的T评分从-2.7 SD增至-2.4 SD。结论 正确测量和分析技术对获得可靠诊断结果至关重要,需要进一步认真研究。
[关键词] 测量;股骨;骨密度
Research on measurement technology of bone mineral density at lumber and hip
CUI Xia,QIN Lin-lin,LIU Hong-e,et al.Nuclear Medicine Department,China-Japan Friendship Hospital,Beijing 100029,China
[Abstract] Objective Through research on measurement technology of bone mineral density(BMD)at lumber and hip,point out some important technology in measurement and analysis.Methods The different result of scan at hip were compared using standard and thin X ray for patients.When T score different of close two lumbers were large than 1 SD,the different result was reported and reason was analyzed.When slight moving ROI position of neck,different results of BMD and T score at neck,trocant and total hip were compared.Results Bone edge was more clear and BMD of average parts at hip were larger when using thin X ray than standard X-ray for thin patients.T score different of close two lumbers was less 1SD for healthy subjects.T score different of L3 and L4 was 2.2SD for patient 1,T score different of L2 and L3 was 1.3 SD for patient 2.T score different of L2 and L3 was 1.5 SD for patient 3.ROI position at neck slight was moving from 120 to 124 of X axis.T score at neck was changed from -2.4 to -2.7 SD.Conclusion Correct measurement and analysis technology is very important for diagnosing osteoporosis,more technology key needed further discussed. 论文网在线
[Key words] measurement;femur;bone mineral density
骨密度测量广泛应用在对骨折发生率的预测中,双能X线骨密度仪(DXA)是国际公认精确度高、扫描速度快的诊断骨质疏松测量仪[1],常规测量腰椎、股骨近端两个部位。在骨密度测量中对患者的摆位和影像分析是测量技术中两个重要方面。不正确摆位和对图像的'错误分析及报告会导致不正确的测量结果和错误的诊断[2]。本文对我院骨密度测量患者进行回顾性研究,指出在患者测量中易发生的几种错误,说明正确测量和分析技术的重要性,它是获得对骨质疏松诊断结果的基础保证。
1 资料与方法
1.1 一般资料 随机选1例正常人和3例严重骨病男性患者对其L1~4椎体BMD、T评分和椎体高度结果进行比较和分析。
1.2 方法 自2004年7月开始,使用我院新后的GE Lunar Prodigy双能X线骨密度仪,应用常规标准软件测量腰椎、股骨近端两个部位,按要求对患者体位摆放、分析图像,参照WHO诊断标准[3]报告结果,对其中发现的技术问题,分不同部位和情况进行研究和分析。
1.2.1 不同束型选择对结果的影响 对扫描腰椎、股骨的患者,采用3 mA标准束按照程序先进行股骨近端扫描,对身材较瘦的患者看到扫描结果大转子边缘有缺损时,在患者体位不变的情况下重新扫描,将束型调整为0.75 mA薄型射束,选3例比较两种不同束型在股骨颈、大转子和全股骨近各部位BMD、T评分结果的不同。