老年患者的骨质疏松症影像学检查
Osteoporosis Imaging in the Geriatric Patient.
作者信息
Heilmeier Ursula, Youm Jiwon, Torabi Soheyla, Link Thomas M
机构信息
Musculoskeletal Quantitative Imaging Research Group, Department of Radiology & Biomedical Imaging, University of California, San Francisco, 185 Berry Street, Lobby 6, Suite 350, San Francisco, CA 94158, USA.
Musculoskeletal Quantitative Imaging Research Group, Department of Radiology & Biomedical Imaging, University of California, San Francisco, 185 Berry Street, Lobby 6, Suite 350, San Francisco, CA 94158, USA; Department of Radiology and Biomedical Imaging, School of Medicine, University of California San Francisco , 400 Parnassus Avenue, UC Clinics, Room 367, San Francisco, CA 94143, USA.
出版信息
Curr Radiol Rep. 2016 Apr;4(4). doi: 10.1007/s40134-016-0144-1. Epub 2016 Feb 15.
Given the expected rapid growth of the geriatric world population (=individuals aged >65 years) to 1.3 billion by 2050, age-related diseases such as osteoporosis and its sequelae, osteoporotic fractures, are on the rise. Areal bone mineral density (aBMD) by dual-energy X-ray absorptiometry (DXA) is the current gold standard to diagnose osteoporosis, to assess osteoporotic fracture risk, and to monitor treatment-induced BMD changes. However, most fragility fractures occur in patients with normal or osteopenic aBMD, indicating that factors beyond BMD impact bone strength. Recent developments in DXA technology such as TBS, VFA, and hip geometry analysis are now available to assess some of these non-BMD parameters from the DXA image. This review will discuss the use of DXA and DXA-assisted technologies and their respective advantages and disadvantages. Special attention is given to if and how each method is indicated in the geriatric population, and the latest ISCD 2015 guidelines have been incorporated.
鉴于预计到2050年老年世界人口（即年龄超过65岁的个体）将迅速增长至13亿，骨质疏松症及其后遗症、骨质疏松性骨折等与年龄相关的疾病正在增加。通过双能X线吸收法（DXA）测量的面积骨密度（aBMD）是目前诊断骨质疏松症、评估骨质疏松性骨折风险以及监测治疗引起的骨密度变化的金标准。然而，大多数脆性骨折发生在aBMD正常或骨量减少的患者中，这表明除骨密度外的其他因素也会影响骨强度。DXA技术的最新进展，如骨小梁评分（TBS）、椎体骨折评估（VFA）和髋部几何分析，现在可用于从DXA图像评估其中一些非骨密度参数。本综述将讨论DXA及DXA辅助技术的应用及其各自的优缺点。特别关注每种方法在老年人群中的适用情况及方式，并纳入了最新的2015年国际临床骨密度学会（ISCD）指南。
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