Pezzuti Isabela Leite, Kakehasi Adriana Maria, Filgueiras Maria Tereza, de Guimarães Juliana Albano, de Lacerda Isabela Alves Campos, Silva Ivani Novato
Department of Pediatrics, Division of Pediatric Endocrinology, Faculdade de Medicina/Hospital das Clínicas, Universidade Federal de Minas Gerais (UFMG) Av. Alfredo Balena 190, s/267 30130-100, Belo Horizonte, MG.
Department of Locomotor System, Faculdade de Medicina/Hospital das Clínicas niversidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG.
J Pediatr Endocrinol Metab. 2017 May 1;30(5):485-497. doi: 10.1515/jpem-2016-0252.
The objective of the work was to prepare an update on imaging methods for bone evaluation during childhood and adolescence. The text was based on original and review articles on imaging methods for clinical evaluation of bone mass in children and adolescents up to 20 years old. They were selected from BIREME and PUBMED by means of the following keywords: bone density; osteoporosis/diagnosis; densitometry; tomography; ultrasonography; magnetic resonance imaging; and radiogrammetry and published in Portuguese or English, in the last 10 years (2006-2016). The article was organized into topics with the description of peculiarities, advantages and disadvantages of each imaging method and their possible clinical applicability. Despite the emergence of new technologies, dual energy X-ray absorptiometry (DXA) remains the gold standard method for low bone mass diagnosis in all age groups. However, interpretation is complex in children and adolescents and demands skilled people. Quantitative computed tomography (QCT) [central QCT, peripheral QCT (pQCT) and high resolution-pQCT (HR-pQCT)] and magnetic resonance imaging (MRI) evaluate real bone density, but are not yet available for routine use. Quantitative bone ultrasound (QUS) shows good perspectives for its use in primary prevention actions. Automated radiogrammetry shows promise as a method able to flag individuals who might benefit from a complete bone assessment, but the clinical value of the measures still needs to be established.
这项工作的目的是编写一份关于儿童和青少年时期骨骼评估成像方法的最新资料。本文基于有关20岁以下儿童和青少年骨量临床评估成像方法的原创文章和综述文章。通过以下关键词从BIREME和PUBMED中选取：骨密度；骨质疏松症/诊断；骨密度测定法；体层摄影术；超声检查；磁共振成像；以及X线骨密度测量法，这些文章于过去10年（2006 - 2016年）以葡萄牙语或英语发表。文章按主题组织，描述了每种成像方法的特点、优缺点及其可能的临床适用性。尽管新技术不断涌现，但双能X线吸收法（DXA）仍然是所有年龄组低骨量诊断的金标准方法。然而，在儿童和青少年中其解读较为复杂，需要专业人员。定量计算机断层扫描（QCT）[中心QCT、外周QCT（pQCT）和高分辨率 - pQCT（HR - pQCT）]以及磁共振成像（MRI）可评估真实骨密度，但尚未用于常规检查。定量骨超声（QUS）在初级预防行动中的应用前景良好。自动X线骨密度测量法有望成为一种能够识别可能从全面骨评估中受益个体的方法，但其测量的临床价值仍有待确定。
