Wu C, Hans D, He Y, Fan B, Njeh C F, Augat P, Richards J, Genant H K
Osteoporosis and Arthritis Research Group, Department of Radiology, University of California, San Francisco, San Francisco, CA 94117-0784, USA.
Bone. 2000 May;26(5):529-33. doi: 10.1016/S8756-3282(00)00250-7.
This investigation compares quantitative ultrasound (QUS) measurement of the phalanges with peripheral quantitative computed tomography (pQCT) and dual X-ray absorptiometry (DXA) measurement of the forearm, to estimate the strength of the distal radius in 13 cadaveric forearms. The cadavers were scanned at the distal radius by pQCT and DXA for bone mineral density (BMD) and at the approximate phalanges by QUS for speed of sound (SOS). The distal radii were subjected to a simulated Colles fracture produced with a materials testing machine. The load at which the distal radius was fractured was considered as a representation of bone strength. The bone strength correlated significantly with SOS at different phalanges (r = 0.63-0.72), BMD at different regions of interest by DXA (r = 0.67-0.75), and cortical BMD at different sites by pQCT (r = 0.61-0.67). Standard stepwise regression analysis showed that adding phalangeal SOS into forearm densitometric variables significantly enhanced the statistical power for prediction of the strength of the distal radius. Our results suggest that, for assessment of site-specific distal forearm strength, QUS measurement of the phalanges is comparable to forearm densitometry. Phalangeal QUS may add clinical value if distal forearm strength has a high priority.
本研究比较了指骨的定量超声（QUS）测量与前臂的外周定量计算机断层扫描（pQCT）及双能X线吸收法（DXA）测量，以评估13具尸体前臂远端桡骨的强度。通过pQCT和DXA对尸体的远端桡骨进行扫描以测量骨密度（BMD），通过QUS对近似指骨进行扫描以测量声速（SOS）。使用材料试验机对远端桡骨施加模拟的科雷氏骨折。将远端桡骨骨折时的负荷视为骨强度的代表。骨强度与不同指骨的SOS显著相关（r = 0.63 - 0.72），与DXA在不同感兴趣区域的BMD显著相关（r = 0.67 - 0.75），与pQCT在不同部位的皮质骨BMD显著相关（r = 0.61 - 0.67）。标准逐步回归分析表明，将指骨SOS添加到前臂骨密度测量变量中可显著提高预测远端桡骨强度的统计效能。我们的结果表明，对于评估特定部位的前臂远端强度，指骨的QUS测量与前臂骨密度测量相当。如果前臂远端强度是高度优先考虑的因素，指骨QUS可能会增加临床价值。
