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射频超声多光谱法在评估腰椎骨关节炎人群骨密度中的优势

The Advantages of Radiofrequency Echographic MultiSpectrometry in the Evaluation of Bone Mineral Density in a Population with Osteoarthritis at the Lumbar Spine.

作者信息

Caffarelli Carla, Al Refaie Antonella, Mondillo Caterina, Manasse Giuditta, Versienti Alessandro, Tomai Pitinca Maria Dea, Conticini Edoardo, Frediani Bruno, Gonnelli Stefano

机构信息

Section of Internal Medicine, Department of Medicine, Surgery and Neuroscience, University of Siena, 53100 Siena, Italy.

Rheumatology Unit, Department of Medicine, Surgery and Neuroscience, University of Siena, 53100 Siena, Italy.

出版信息

Diagnostics (Basel). 2024 Mar 1;14(5):523. doi: 10.3390/diagnostics14050523.

Abstract

BACKGROUND

Osteoarthritis (OA) in the lumbar spine can potentially lead to an overestimation of bone mineral density (BMD), and this can be a challenge in accurately diagnosing conditions like osteoporosis, where precise measurement of BMD is crucial. Radiofrequency Echographic Multi Spectrometry (REMS) is being recognized as an innovative diagnostic tool for assessing bone status. The purpose of this study was to evaluate whether the use of REMS may enhance the identification of osteoporosis in patients with osteoarthritis.

METHODS

A cohort of 500 patients (mean age: 63.9 ± 11.2 years) diagnosed with osteoarthritis and having a medical prescription for dual-energy X-ray absorptiometry (DXA) were recruited for the study. All patients underwent BMD measurements at lumbar spine and femoral sites by both DXA and REMS techniques.

RESULTS

The T-score values for BMD at the lumbar spine (BMD-LS) by DXA were significantly higher with respect to BMD-LS by REMS across all OA severity scores, and the differences were more pronounced in patients with a higher degree of OA severity ( < 0.001). Furthermore, the percentage of subjects classified as "osteoporotic", on the basis of BMD by REMS was markedly higher than those classified by DXA, both when considering all skeletal sites (39.4% vs. 15.1%, respectively) and the lumbar spine alone (30.5% vs. 6.0%, respectively). A similar pattern was observed when OA patients were grouped according to the Kellgren-Lawrence grading score.

CONCLUSIONS

The findings from our study indicate that, in a population with varying severity levels of osteoarthritis, REMS demonstrated a higher capability to diagnose osteoporosis compared to DXA, and this could lead to earlier intervention and improved outcomes for patients with bone fragility, reducing the likelihood of fractures and associated complications.

摘要

背景

腰椎骨关节炎(OA)可能会导致骨密度(BMD)被高估,而这在准确诊断骨质疏松症等疾病时可能构成挑战,因为在这些疾病中,BMD的精确测量至关重要。射频超声多光谱测定法(REMS)正被视为一种评估骨状态的创新诊断工具。本研究的目的是评估使用REMS是否能提高骨关节炎患者骨质疏松症的识别率。

方法

招募了500名被诊断为骨关节炎且有双能X线吸收法(DXA)医学处方的患者(平均年龄:63.9±11.2岁)参与本研究。所有患者均通过DXA和REMS技术在腰椎和股骨部位进行了BMD测量。

结果

在所有OA严重程度评分中,DXA测量的腰椎骨密度(BMD-LS)的T值显著高于REMS测量的BMD-LS,且在OA严重程度较高的患者中差异更为明显(<0.001)。此外,无论是考虑所有骨骼部位(分别为39.4%和15.1%)还是仅考虑腰椎(分别为30.5%和6.0%),基于REMS的BMD被归类为“骨质疏松症”的受试者百分比均明显高于基于DXA的受试者。当根据Kellgren-Lawrence分级评分对OA患者进行分组时,观察到了类似的模式。

结论

我们的研究结果表明,在骨关节炎严重程度不同的人群中,与DXA相比,REMS在诊断骨质疏松症方面表现出更高的能力,这可能会为骨脆性患者带来更早的干预和更好的治疗效果,降低骨折及相关并发症的发生可能性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ec1f/10930380/5321bcf6a5bf/diagnostics-14-00523-g001.jpg

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