Glüer Claus-C, Barkmann Reinhard
Medical Physics, Department of Diagnostic Radiology, University Hospital Schleswig-Holstein, Campus Kiel, Michaelisstrasse 9, D-24105 Kiel, Germany.
Curr Osteoporos Rep. 2003 Dec;1(3):98-104. doi: 10.1007/s11914-996-0003-8.
Quantitative ultrasound (QUS) techniques have found widespread clinical use, but their specific role in clinical practice needs further refinement. This review discusses the ability of QUS approaches to predict the risk for prevalent vertebral fractures and the risk for future fractures. QUS approaches perform as well as central dual x-ray absorptiometry devices but with some disadvantages (at least for older QUS approaches) with regard to the predictive power for hip fractures. Technologic diversity of QUS approaches may lead to differences in performance. QUS also has the potential for assessing bone mineral density-independent aspects of bone composition that are relevant for bone strength. For measurements at the calcaneus, it is evident that bone microstructure is the key determinant of QUS variables obtained. However, in most cases, microstructure is so highly correlated with bone mineral density that no separate assessment can be performed in clinical practice. At cortical sites, a selective assessment of bone properties is easier. Technologies need to be adapted to this purpose because requirements differ significantly from those desired for optimum fracture risk assessment. More importantly, multiple partially independent QUS variables need to be defined to assess complementary aspects of bone tissue.
定量超声（QUS）技术已在临床广泛应用，但其在临床实践中的具体作用仍需进一步明确。本综述讨论了QUS方法预测现患椎体骨折风险和未来骨折风险的能力。QUS方法与中央双能X线吸收仪的性能相当，但在预测髋部骨折方面存在一些劣势（至少对于较老的QUS方法而言）。QUS方法的技术多样性可能导致性能差异。QUS还具有评估与骨强度相关的骨成分中与骨矿物质密度无关方面的潜力。对于跟骨测量，很明显骨微结构是所获得的QUS变量的关键决定因素。然而，在大多数情况下，微结构与骨矿物质密度高度相关，以至于在临床实践中无法进行单独评估。在皮质部位，对骨特性进行选择性评估更容易。技术需要为此目的进行调整，因为其要求与最佳骨折风险评估所需的要求有很大不同。更重要的是，需要定义多个部分独立的QUS变量来评估骨组织的互补方面。
