McCauley E, Mackie A, Elliott D, Chuck A
Regional Medical Physics Department, University Hospital of North Durham, North Road, Durham DH1 5TW, UK.
Br J Radiol. 2006 Jun;79(942):464-7. doi: 10.1259/bjr/47352663.
A diagnosis of osteoporosis is facilitated by bone mineral density (BMD) measurement of the lumbar spine and hip using dual energy X-ray absorptiometry (DXA), interpreted in accordance with criteria published by the World Health Organization (WHO). The use of peripheral DXA is growing in primary care and guidance on its use has recently been published by the National Osteoporosis Society (NOS), recommending a triage approach using thresholds specific to each type of peripheral device. However, no data currently exist for the Norland Apollo heel densitometer (Cooper Surgical, Trumbull, USA). 215 women between 50 years and 75 years of age (mean age 64.6 years) referred for hip and spine BMD measurements also had a heel BMD measurement. Device specific upper and lower thresholds were calculated for the Norland Apollo heel densitometer to give a 90% sensitivity and 90% specificity for osteoporosis at the hip or spine. Patients with a heel T-score of above -1.2 are very likely to have normal bone density on axial densitometry, whilst patients with heel T-score of below -2.2 are very likely to have osteoporosis at the hip or spine. Patients whose measurements lie between the thresholds should be referred for axial DXA.
采用双能X线吸收法（DXA）测量腰椎和髋部的骨矿物质密度（BMD），并根据世界卫生组织（WHO）发布的标准进行解读，有助于骨质疏松症的诊断。在基层医疗中，外周DXA的使用正在增加，英国国家骨质疏松协会（NOS）最近发布了关于其使用的指南，建议采用针对每种外周设备特定阈值的分诊方法。然而，目前尚无关于诺兰德阿波罗足跟骨密度仪（美国特朗布尔库珀外科公司）的数据。215名年龄在50岁至75岁之间（平均年龄64.6岁）因髋部和脊柱BMD测量而转诊的女性也进行了足跟BMD测量。计算出诺兰德阿波罗足跟骨密度仪特定设备的上下阈值，以在髋部或脊柱处对骨质疏松症给出90%的敏感性和90%的特异性。足跟T值高于-1.2的患者在轴向骨密度测量中骨密度很可能正常，而足跟T值低于-2.2的患者在髋部或脊柱处很可能患有骨质疏松症。测量值介于阈值之间的患者应转诊进行轴向DXA检查。
