Kiebzak Gary M, Binkley Neil, Lewiecki E Michael, Miller Paul D
Center for Orthopaedic Research and Education, St Luke's Episcopal Hospital, Houston, TX 77025, USA.
J Clin Densitom. 2007 Apr-Jun;10(2):132-7. doi: 10.1016/j.jocd.2007.02.003. Epub 2007 Apr 9.
In 1997, the National Health and Nutrition Examination Survey III (NHANES III) total hip reference database was adopted for T-score derivation in an effort to optimize diagnostic agreement among densitometers from different manufacturers. Our study was undertaken to evaluate the effectiveness of the NHANES III standardized database at achieving agreement in diagnostic classification (normal, osteopenia, or osteoporosis) based on total hip T-scores comparing 2 different dual-energy X-ray absorptiometry (DXA) systems. This was a retrospective analysis of standard bilateral hip and lumbar spine scans done in duplicate for 60 women scanned on both a GE Lunar Prodigy and Hologic Delphi DXA system. Classification based on lumbar spine T-scores using manufacturer-specific databases was also compared as no standardized lumbar spine reference database exists. Subject's mean age was 62 yr (range: 47-83 yr). There was no statistically significant difference in diagnostic classification between DXA systems (Prodigy vs Delphi), with agreement (same women classified same way) of 92% at the left total hip. Agreement was 100% when T-scores were greater than or equal to -0.8 and less than or equal to -1.2. There was 90% agreement between DXA systems at the lumbar spine. For both hip and spine, all diagnostic discrepancies occurred when the T-scores were at or near transition thresholds between normal and osteopenia or osteopenia and osteoporosis. The difference in mean T-scores between DXA systems at left total hip was 0.11 vs 0.32 for lumbar spine (p less than 0.001). Use of the NHANES III standardized database results in good diagnostic agreement at total hip between Prodigy and Delphi.
1997年，采用了美国国家健康与营养检查调查第三次（NHANES III）全髋关节参考数据库来推导T值，以优化不同制造商骨密度仪之间的诊断一致性。我们开展这项研究是为了评估NHANES III标准化数据库在基于全髋关节T值实现诊断分类（正常、骨量减少或骨质疏松）一致性方面的有效性，比较两种不同的双能X线吸收法（DXA）系统。这是一项回顾性分析，对60名女性进行了标准双侧髋关节和腰椎扫描，她们分别在GE Lunar Prodigy和Hologic Delphi DXA系统上进行了重复扫描。由于不存在标准化的腰椎参考数据库，还比较了使用制造商特定数据库基于腰椎T值的分类。受试者的平均年龄为62岁（范围：47 - 83岁）。DXA系统（Prodigy与Delphi）之间的诊断分类没有统计学上的显著差异，左全髋关节的一致性（相同女性分类方式相同）为92%。当T值大于或等于 -0.8且小于或等于 -1.2时，一致性为100%。DXA系统在腰椎的一致性为90%。对于髋关节和脊柱，所有诊断差异都发生在T值处于正常与骨量减少或骨量减少与骨质疏松之间的转换阈值或接近该阈值时。左全髋关节DXA系统之间的平均T值差异为0.11，而腰椎为0.32（p小于0.001）。使用NHANES III标准化数据库可使Prodigy和Delphi在全髋关节处获得良好的诊断一致性。
