Department of Medicine, Columbia University College of Physicians and Surgeons, New York, NY, USA.
Ultrasound Med Biol. 2013 Mar;39(3):388-95. doi: 10.1016/j.ultrasmedbio.2012.09.024. Epub 2013 Jan 11.
The objectives of this study were to evaluate the capability of a novel ultrasound device to clinically estimate bone mineral density (BMD) at the 1/3 radius. The device rests on a desktop and is portable, and permits real-time evaluation of the radial BMD. The device measures two net time delay (NTD) parameters, NTD(DW) and NTD(CW). NTD(DW) is defined as the difference between the transit time of an ultrasound pulse to travel through soft-tissue, cortex and medullary cavity, and the transit time through soft tissue only of equal overall distance. NTD(CW) is defined as the difference between the transit time of an ultrasound pulse to travel through soft-tissue and cortex only, and the transit time through soft tissue only again of equal overall distance. The square root of the product of these two parameters is a measure of the radial BMD at the 1/3 location as measured by dual-energy X-ray absorptiometry (DXA). A clinical IRB-approved study measured ultrasonically 60 adults at the 1/3 radius. BMD was also measured at the same anatomic site and time using DXA. A linear regression using NTD produced a linear correlation coefficient of 0.93 (p < 0.001). These results are consistent with previously reported simulation and in vitro studies. In conclusion, although X-ray methods are effective in bone mass assessment, osteoporosis remains one of the largest undiagnosed and under-diagnosed diseases in the world today. The research described here should enable significant expansion of diagnosis and monitoring of osteoporosis through a desktop device that ultrasonically assesses bone mass at the 1/3 radius.
本研究的目的是评估一种新型超声设备在临床评估 1/3 桡骨骨密度(BMD)方面的能力。该设备放置在桌面上,体积小巧,可实时评估桡骨 BMD。该设备测量两个净时间延迟(NTD)参数,NTD(DW)和 NTD(CW)。NTD(DW)定义为超声脉冲穿过软组织、皮质和骨髓腔的传输时间与穿过等长软组织的传输时间之差。NTD(CW)定义为超声脉冲穿过软组织和皮质的传输时间与穿过等长软组织的传输时间之差。这两个参数的乘积的平方根是双能 X 射线吸收法(DXA)测量的 1/3 桡骨处的桡骨 BMD 的度量。一项经临床 IRB 批准的研究在 1/3 桡骨处用超声测量了 60 名成年人。同时,在相同的解剖部位和时间使用 DXA 测量了 BMD。使用 NTD 的线性回归产生了 0.93 的线性相关系数(p < 0.001)。这些结果与先前报道的模拟和体外研究一致。总之,尽管 X 射线方法在骨量评估中有效,但骨质疏松症仍然是当今世界上最大的未确诊和未充分诊断的疾病之一。这里描述的研究应该能够通过一种在桌面上评估 1/3 桡骨骨密度的超声设备,显著扩大骨质疏松症的诊断和监测。