Wong Andy K O, Beattie Karen A, Min Kevin K H, Merali Zamir, Webber Colin E, Gordon Christopher L, Papaioannou Alexandra, Cheung Angela M W, Adachi Jonathan D
Department of Medicine, McMaster University, Hamilton, ON, Canada.
Department of Medicine, McMaster University, Hamilton, ON, Canada.
J Clin Densitom. 2015 Jul-Sep;18(3):408-18. doi: 10.1016/j.jocd.2014.07.003. Epub 2014 Aug 13.
Part II of this 3-part series demonstrated 1-yr precision, standard error of the estimate, and 1-yr least significant change for volumetric bone outcomes determined using peripheral (p) quantitative computed tomography (QCT) and peripheral magnetic resonance imaging (pMRI) modalities in vivo. However, no clinically relevant outcomes have been linked to these measures of change. This study examined 97 women with mean age of 75 ± 9 yr and body mass index of 26.84 ± 4.77 kg/m(2), demonstrating a lack of association between fragility fractures and standard deviation, least significant change and standard error of the estimate-based unit differences in volumetric bone outcomes derived from both pMRI and pQCT. Only cortical volumetric bone mineral density and cortical thickness derived from high-resolution pQCT images were associated with an increased odds for fractures. The same measures obtained by pQCT erred toward significance. Despite the smaller 1-yr and short-term precision error for measures at the tibia vs the radius, the associations with fractures observed at the radius were larger than at the tibia for high-resolution pQCT. Unit differences in cortical thickness and cortical volumetric bone mineral density able to yield a 50% increase in odds for fractures were quantified here and suggested as a reference for future power computations.
这个3部分系列的第二部分展示了使用外周（p）定量计算机断层扫描（QCT）和外周磁共振成像（pMRI）模式在体内确定的骨体积结果的1年精度、估计标准误差和1年最小显著变化。然而，尚未将任何临床相关结果与这些变化测量指标联系起来。本研究调查了97名平均年龄为75±9岁、体重指数为26.84±4.77kg/m²的女性，结果表明，脆性骨折与pMRI和pQCT得出的骨体积结果的标准差、最小显著变化以及基于估计标准误差的单位差异之间缺乏关联。只有从高分辨率pQCT图像得出的皮质骨体积骨密度和皮质厚度与骨折几率增加有关。通过pQCT获得的相同测量指标倾向于具有显著性。尽管胫骨测量指标的1年和短期精度误差比桡骨小，但对于高分辨率pQCT，在桡骨观察到的与骨折的关联大于胫骨。本文对能够使骨折几率增加50%的皮质厚度和皮质骨体积骨密度单位差异进行了量化，并建议作为未来功效计算的参考。
