Boyanov M, Shinkov A, Nestorova R
Klinik für Endokrinologie, Alexandrovska Spital, Medizinische Universität Sofia.
Dtsch Med Wochenschr. 2007 Apr 20;132(16):869-73. doi: 10.1055/s-2007-973630.
Quantitative ultrasound (QUS) has been successfully used for more than a decade in predicting the risk of osteoporotic fractures. However, the "gold standard" in the diagnosis of osteoporosis is dual-energy X-ray absorptiometry (DXA). The aim of this study was to perform QUS at the calcaneus and distal radius, as well as DXA over the lumbar spine and proximal femur in women and to compare both QUS results with the DXA ones.
230 postmenopausal Bulgarian women, aged between 42 and 80 years, took part in this study. QUS was performed ar the calcaneus and the radius. At the calcaneus the "quantitative ultrasound index" (QUI) was used, but at the radius the speed of sound (SOS) T-scores (SD's under the mean value for young healthy adults) were calculated.
The highest accuracy was observed at the radius (coefficient of variance 0.59 %), followed by that for the total hip (0.95 %). The lowest mean T-scores were found at the lumbar spine (-1.94), followed by the calcaneus (-1.85) und radius (-1.74). The correlation coefficients between calcaneal QUI and BMD of the lumbar spine and proximal femur were 0,285 and 0.442 (p=0.059 and 0.001, respectively); the corresponding values for radial SOS were 0.201 and 0.061 (p=0.019 and 0.513, respectively: no significant difference). T-scores of -1.0 for the Sahara device and of -0.5 for the Sunlight device identified women without spinal osteoporosis with a 90% probability.
Women with normal bone density of the proximal femur were better identified using transverse QUS at the calcaneus. Both QUS techniques (transverse and axial) are well suited for identifying women without osteoporosis of the lumbar spine.
十多年来，定量超声（QUS）已成功用于预测骨质疏松性骨折的风险。然而，骨质疏松症诊断的“金标准”是双能X线吸收法（DXA）。本研究的目的是对女性跟骨和桡骨远端进行QUS检查，并对腰椎和股骨近端进行DXA检查，然后将QUS结果与DXA结果进行比较。
230名年龄在42至80岁之间的保加利亚绝经后女性参与了本研究。对跟骨和桡骨进行了QUS检查。在跟骨处使用“定量超声指数”（QUI），而在桡骨处计算声速（SOS）T值（相对于年轻健康成年人平均值的标准差）。
桡骨处的准确性最高（变异系数为0.59%），其次是全髋（0.95%）。腰椎处的平均T值最低（-1.94），其次是跟骨（-1.85）和桡骨（-1.74）。跟骨QUI与腰椎和股骨近端骨密度的相关系数分别为0.285和0.442（p值分别为0.059和0.001）；桡骨SOS的相应值为0.201和0.061（p值分别为0.019和0.513，无显著差异）。Sahara设备的T值为-1.0以及Sunlight设备的T值为-0.5时，识别无脊柱骨质疏松症女性的概率为90%。
使用跟骨横向QUS能更好地识别股骨近端骨密度正常的女性。两种QUS技术（横向和轴向）都非常适合识别无腰椎骨质疏松症的女性。
