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[骨密度测量解读中的陷阱与困难]

[Pitfalls and difficulties in interpretation of bone densitometry].

作者信息

Scholz R, Borte G, von Salis-Soglio G, Heyde C-E

机构信息

Orthopädische Klinik und Poliklinik, Universität Leipzig, Liebigstr. 20, 04103, Leipzig, Deutschland.

出版信息

Orthopade. 2010 Apr;39(4):361-70. doi: 10.1007/s00132-010-1613-5.

Abstract

The clinical relevance of osteoporosis as a frequent systemic skeletal disease is to be found in fractures and their consequences. For prevention of these disease manifestations great importance must be attached to a safest possible diagnosis even before the occurrence of the first fracture and osteodensitometry is a well established technique for this purpose. Among the different measurement procedures DXA (dual-energy X-ray absorptiometry) has become the gold standard worldwide. This method is seen as very reliable and adequately precise. Prerequisites for these characteristics are the correct interpretation of the measurement data obtained by taking into consideration all potential influencing factors which can either false positively or false negatively influence a single value as well as the calculated mean value and the T and Z scores. Thus, exact knowledge of potential sources of error is of crucial importance. The present study shows important sources of error and difficulties in interpretation as well as a discussion of the options for their prevention. For the clinical practice osteodensitometry is to be seen as an important diagnostic component, which can only been interpreted meaningfully with respect to the clinical data.

摘要

骨质疏松症作为一种常见的全身性骨骼疾病,其临床相关性体现在骨折及其后果上。为预防这些疾病表现,即使在首次骨折发生之前,尽可能安全的诊断也至关重要,而骨密度测定是实现这一目的的成熟技术。在不同的测量方法中,双能X线吸收法(DXA)已成为全球的金标准。该方法被认为非常可靠且精度足够。这些特性的前提是通过考虑所有可能对单个值以及计算出的平均值和T值及Z值产生假阳性或假阴性影响的潜在影响因素,对获得的测量数据进行正确解读。因此,准确了解潜在误差来源至关重要。本研究展示了重要的误差来源和解读困难,以及对预防这些误差的方法的讨论。对于临床实践而言,骨密度测定应被视为一项重要的诊断组成部分,只有结合临床数据才能进行有意义的解读。

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