Van Berkum F N, Birkenhäger J C, Van Veen L C, Zeelenberg J, Birkenhäger-Frenkel D H, Trouerbach W T, Stijnen T, Pols H A
Department of Internal Medicine III and Clinical Endocrinology, University Hospital of Rotterdam Dijkzigt, Erasmus University of Rotterdam, The Netherlands.
J Bone Miner Res. 1989 Oct;4(5):679-85. doi: 10.1002/jbmr.5650040506.
We compared different methods of bone densitometry in women with spinal osteoporosis and normal subjects to assess their discriminatory capability. The methods used included: quantitative computed tomography of the spine (QCT) specified as to trabecular (QCTtrab) and cortical bone (QCTcort), dual-photon absorptiometry of the spine (DPAspine), single-photon absorptiometry of the distal and proximal forearm (SPAdist and SPAprox), and quantitative roentgen microdensitometry of the phalanx (QMD). A total of 25 postmenopausal osteoporotic women and 24 healthy comparison subjects matched for age and years since menopause were studied. In the osteoporotic group an average decrement of the axial bone mineral density of -50% (p less than 0.001) and -20% (p less than 0.001) were observed for QCTtrab and QCTcort, respectively. For DPAspine, SPAdist, SPAprox, and QMD the difference between normal and osteoporotic subjects was -20% (p less than 0.001), -12% (p less than 0.05), -7% (NS), and -6% (NS), respectively. With the peripheral measurements (SPA and QMD), alone or in combination, no adequate discrimination between women with or without vertebral compression fractures could be obtained. Although QCTtrab showed the highest diagnostic sensitivity (81%), it appears not to be superior to DPAspine. Combinations of the various axial and peripheral measurements did not result in an essentially better sensitivity. In normal women as well as in osteoporotic individuals the trabecular and cortical QCT measurements showed two opposite trends, suggesting an increase in cortical and a decrease in trabecular density from L1 to L3.
我们比较了患有脊柱骨质疏松症的女性和正常受试者的不同骨密度测量方法，以评估它们的鉴别能力。所用方法包括：脊柱定量计算机断层扫描（QCT），分为小梁骨（QCTtrab）和皮质骨（QCTcort）；脊柱双能光子吸收法（DPAspine）；远端和近端前臂单能光子吸收法（SPAdist和SPAprox）；以及指骨定量X线显微密度测定法（QMD）。共研究了25名绝经后骨质疏松症女性和24名年龄及绝经年限相匹配的健康对照受试者。在骨质疏松症组中，QCTtrab和QCTcort测得的轴向骨矿物质密度平均分别下降了50%（p<0.001）和20%（p<0.001）。对于DPAspine、SPAdist、SPAprox和QMD，正常受试者与骨质疏松症受试者之间的差异分别为-20%（p<0.001）、-12%（p<0.05）、-7%（无显著性差异）和-6%（无显著性差异）。仅通过外周测量（SPA和QMD）或其联合使用，无法对有无椎体压缩骨折的女性进行充分鉴别。尽管QCTtrab显示出最高的诊断敏感性（81%），但似乎并不优于DPAspine。各种轴向和外周测量方法的联合使用并未带来本质上更高的敏感性。在正常女性和骨质疏松症个体中，小梁骨和皮质骨的QCT测量结果呈现出两种相反的趋势，表明从L1到L3皮质骨密度增加，小梁骨密度降低。
