Ito Masako, Nishida Akifumi, Kono Jun, Kono Mika, Uetani Masataka, Hayashi Kuniaki
Department of Radiology, Nagasaki University School of Medicine, 1-7-1 Sakamoto, 852-8501, Nagasaki, Japan.
Osteoporos Int. 2003 Dec;14(12):959-64. doi: 10.1007/s00198-003-1497-x. Epub 2003 Aug 29.
Long-term precision, as well as reproducibility, is important for monitoring bone mineral density (BMD) alteration in response to aging or therapy. In order to investigate which bone densitometry and which skeletal site are clinically useful for monitoring bone mass, we examined the standardized long-term precision of several bone density measurements in 83 healthy Japanese women. Annual BMD measurements were performed for 5 or 6 years using dual X-ray absorptiometry (DXA) on the lumbar spine, radius (EXP5000) and calcaneus (HeelScan); peripheral quantitative computed tomography (pQCT) on the radius (Densiscan1000); and quantitative ultrasound (QUS) on the calcaneus (Achilles+). The long-term precision error for the individual subject was given by the standard error of estimate (SEE), and the standardized long-term precision was defined as the percentage coefficient of variation (CV%) divided by the percentage ratio of the annual bone-loss rate. Based on the CV% of spinal DXA, speed of sound (SOS) and diaphyseal pQCT showed significantly higher precision than others, while radial ultradistal (UD) DXA and heel DXA showed significantly lower precision. The long-term precision errors of other measurements were statistically the same as that of the spinal DXA. The spinal DXA, the radial DXA, and pQCT at both the distal metaphysis and diaphysis showed high rates of annual bone loss. The radial trabecular BMD (pQCT) was significantly higher than that of spinal DXA. The annual rates of bone loss of QUS and of heel DXA were significantly lower than that of spinal DXA. Taken together, standardized long-term precision was obtained in the spinal DXA and radial pQCT. In conclusion, spinal DXA and radial pQCT were considered the most useful monitoring method for osteoporosis, while QUS was considered less useful.
长期精度以及可重复性对于监测骨矿物质密度（BMD）随衰老或治疗的变化很重要。为了研究哪种骨密度测量方法以及哪个骨骼部位在临床上对监测骨量有用，我们在83名健康日本女性中检查了几种骨密度测量的标准化长期精度。使用双能X线吸收法（DXA）对腰椎、桡骨（EXP5000）和跟骨（HeelScan）进行了5或6年的年度BMD测量；使用外周定量计算机断层扫描（pQCT）对桡骨（Densiscan1000）进行测量；使用定量超声（QUS）对跟骨（Achilles+）进行测量。个体受试者的长期精度误差由估计标准误差（SEE）给出，标准化长期精度定义为变异系数百分比（CV%）除以年度骨丢失率的百分比。基于脊柱DXA的CV%，声速（SOS）和骨干pQCT的精度显著高于其他方法，而桡骨超远端（UD）DXA和足跟DXA的精度显著较低。其他测量的长期精度误差在统计学上与脊柱DXA相同。脊柱DXA、桡骨DXA以及远端干骺端和骨干的pQCT显示出较高的年度骨丢失率。桡骨小梁BMD（pQCT）显著高于脊柱DXA。QUS和足跟DXA的年度骨丢失率显著低于脊柱DXA。综上所述，脊柱DXA和桡骨pQCT获得了标准化长期精度。总之，脊柱DXA和桡骨pQCT被认为是监测骨质疏松症最有用的方法，而QUS被认为用处较小。
