Xu Xiao-Ming, Li Na, Li Kai, Li Xiao-Yu, Zhang Ping, Xuan Yan-Jiao, Cheng Xiao-Guang
Department of Radiology, Beijing Jishuitan Hospital, No. 31 Xinjiekoudongjie Street, Xicheng District, Beijing 100035, China.
Department of Geriatric, Beijing Jishuitan Hospital, China.
J Orthop Translat. 2018 Dec 21;18:59-64. doi: 10.1016/j.jot.2018.11.003. eCollection 2019 Jul.
The objective of this study was to investigate the diagnostic discordance of osteoporosis by quantitative computed tomography (QCT) and dual-energy X-ray absorptiometry (DXA) in Chinese elderly men.
A total of 313 males older than 60 years, who underwent both spinal QCT and lumbar spine and hip DXA in our department, were included. The diagnostic criteria established by the World Health Organisation in 1994 were used for DXA to diagnose osteoporosis, and the criteria recommended by the International Society of Clinical Densitometry were used for QCT. The osteoporosis detection rate by the two techniques was calculated, and the difference was compared. The minor discordance was considered present when the different diagnostic classes between the two techniques were adjacent. Major discordance was present when the diagnosis by one technique was osteoporosis and the other was normal. The computed tomography images were reviewed by radiologists to assess whether vertebral fracture, aorta calcification or degeneration was present.
In the 313 participants (mean age, 79.6 ± 7.2 years), the osteoporosis detection rate was 10.9% for DXA (lumbar spine and hip) and 45.1% for QCT, a significant difference ( < 0.001). The major discordance, minor discordance and concordance of diagnosis between the two techniques were seen in 8.3%, 50.8% and 40.9%, respectively. QCT detected osteoporosis better than DXA. The causes of this discordance were degeneration of spine, abdominal aorta calcification and vertebral fractures.
Our study demonstrated that discordance was common when using QCT and DXA to diagnose osteoporosis and that spinal degeneration, aorta calcification and fracture obscure the bone mineral density measurement of spine by DXA. QCT is a more sensitive method of choice to identify osteoporosis in elderly Chinese men.
This study investigated the diagnostic discordance of osteoporosis by quantitative computed tomography (QCT) and dual-energy X-ray absorptiometry (DXA) in Chinese elderly men. The results demonstrated that QCT is a more sensitive method of choice to identify osteoporosis in elderly Chinese men. This work may help clinicians make an appropriate choice of technique for the accurate diagnosis of osteoporosis and identify the patients at high risk of osteoporosis who should be treated early to prevent fractures. This may influence the therapeutic plan and the overall prognosis of patients.
本研究旨在调查定量计算机断层扫描（QCT）和双能X线吸收法（DXA）在中国老年男性中对骨质疏松症诊断的不一致性。
纳入313名年龄大于60岁、在我科同时接受了脊柱QCT及腰椎和髋部DXA检查的男性。1994年世界卫生组织制定的诊断标准用于DXA诊断骨质疏松症，国际临床骨密度测量学会推荐的标准用于QCT。计算两种技术的骨质疏松症检出率，并比较差异。当两种技术的不同诊断类别相邻时，认为存在轻度不一致。当一种技术诊断为骨质疏松症而另一种技术诊断为正常时，则存在重度不一致。放射科医生对计算机断层扫描图像进行评估，以判断是否存在椎体骨折、主动脉钙化或退变。
在313名参与者（平均年龄79.6±7.2岁）中，DXA（腰椎和髋部）的骨质疏松症检出率为10.9%，QCT的检出率为45.1%，差异有统计学意义（<0.001）。两种技术诊断的重度不一致、轻度不一致及一致性分别为8.3%、50.8%和40.9%。QCT在诊断骨质疏松症方面优于DXA。这种不一致的原因是脊柱退变、腹主动脉钙化和椎体骨折。
我们的研究表明，使用QCT和DXA诊断骨质疏松症时不一致情况常见，且脊柱退变、主动脉钙化和骨折会影响DXA对脊柱骨密度的测量。QCT是诊断中国老年男性骨质疏松症更敏感的选择方法。
本研究调查了定量计算机断层扫描（QCT）和双能X线吸收法（DXA）在中国老年男性中对骨质疏松症诊断的不一致性。结果表明，QCT是诊断中国老年男性骨质疏松症更敏感的选择方法。这项工作可能有助于临床医生为准确诊断骨质疏松症选择合适的技术，并识别出应尽早治疗以预防骨折的骨质疏松症高危患者。这可能会影响患者的治疗方案和总体预后。
Zotero 插件