Department of Applied Physics, University of Eastern Finland, POB 1627, 70211 Kuopio, Finland.
Osteoporos Int. 2012 Apr;23(4):1287-95. doi: 10.1007/s00198-011-1682-2. Epub 2011 Jun 9.
About 75% of patients suffering from osteoporosis are not diagnosed. This study describes a multi-site bone ultrasound method for osteoporosis diagnostics. In comparison with axial dual energy X-ray absorptiometry (DXA), the ultrasound method showed good diagnostic performance and could discriminate fracture subjects among elderly females.
Axial DXA, the gold standard diagnostic method for osteoporosis, predicts fractures only moderately. At present, no reliable diagnostic methods are available at the primary health care level. Here, a multi-site ultrasound method is proposed for osteoporosis diagnostics.
Thirty elderly women were examined using the ultrasound backscatter measurements in proximal femur, proximal radius, proximal and distal tibia in vivo. First, we predicted the areal bone mineral density (BMD) at femoral neck by ultrasound measurements in tibia combined with specific subject characteristics (density index, DI) and, second, we tested the ability of ultrasound backscatter measurements at proximal femur to discriminate between individuals with previously fractured hips from those without fractures. Areal BMD was determined by axial DXA.
Combined ultrasound parameters, cortical thickness at distal and proximal tibia, with age and weight of the subject, provided a significant estimate of BMD(neck) (r = 0.86, p < 0.001, n = 30). When inserted into FRAX (World Health Organization fracture risk assessment tool), the DI indicated the same treatment proposal as the BMD(neck) with 86% sensitivity and 100% specificity. The receiver operating characteristic analyses, with a combination of ultrasound parameters and patient characteristics, discriminated fracture subjects from the controls similarly as the model combining BMD(neck) and patient characteristics.
For the first time, ultrasound backscatter measurements of proximal femur were conducted in vivo. The results indicate that ultrasound parameters, combined with patient characteristics, may provide a means for osteoporosis diagnostics.
约 75%的骨质疏松症患者未得到诊断。本研究描述了一种多部位骨超声骨质疏松症诊断方法。与轴向双能 X 射线吸收法（DXA）相比，该超声方法具有良好的诊断性能，可区分老年女性中的骨折患者。
轴向 DXA 是骨质疏松症的金标准诊断方法，但仅能中度预测骨折。目前，在初级保健水平上尚无可靠的诊断方法。本文提出了一种多部位超声方法用于骨质疏松症的诊断。
对 30 名老年女性进行了超声背散射测量，包括股骨近端、桡骨近端、胫骨近端和远端。首先，我们通过胫骨中的超声测量值结合特定的个体特征（密度指数，DI）预测股骨颈的面积骨密度（BMD），其次，我们测试了股骨近端超声背散射测量值区分既往髋部骨折患者和无骨折患者的能力。面积骨密度由轴向 DXA 确定。
结合超声参数、远端和近端胫骨的皮质厚度、年龄和体重，可提供 BMD（颈）的显著估计值（r=0.86，p<0.001，n=30）。当插入 FRAX（世界卫生组织骨折风险评估工具）时，DI 表明与 BMD（颈）相同的治疗建议，其灵敏度为 86%，特异性为 100%。采用超声参数和患者特征相结合的受试者工作特征曲线分析，与结合 BMD（颈）和患者特征的模型相似，可区分骨折患者和对照组。
首次在体进行了股骨近端超声背散射测量。结果表明，超声参数结合患者特征，可能为骨质疏松症的诊断提供一种方法。
