Roux C, Lemonnier E, Kolta S, Charpentier E, Dougados M, Amor B, Viens-Bitker C
Clinique de Rhumatologie, Hôpital Cochin, Paris.
Rev Rhum Ed Fr. 1993 Dec;60(12):897-906.
Broadband ultrasound attenuation (BUA) is a new technique for investigating bone status. We evaluated its use in osteoporosis. To assess in vivo reproducibility, we determined the coefficient of variation (cv) on the basis of five measurements (with repositioning) of the same foot in 50 women. The cv was 2.8 +/- 1.7%. BUA values were similar in the right feet and left foot and were correlated with bone density in the calcaneal area investigated (r = 0.8, p < 10(-4). BUA of the calcaneus was correlated with bone density in the lumbar spine, femur, and forearm in 240 healthy postmenopausal women (correlation coefficients 0.36 to 0.55; p < 10(-4)). BUA decreased with age, with a sharper drop during the first years following menopause. Mean broadband ultrasonic attenuation in 37 females with osteoporosis (58.92 +/- 11.59 dB/MHz) is lower than controls (66.10 +/- 15.29 dB/MHz, p = 0.04). Areas under receiver operating characteristic curves, used to evaluate the discriminating value of BUA in osteoporosis and osteopenia, were 0.79 and 0.72, respectively. The kappa coefficient of concordance between BUA and spinal density was 0.59. These data demonstrate that BUA cannot replace bone density measurements. Prospective studies are needed to investigate the potential role of this technique for identifying women at high risk for osteoporotic fractures.
宽带超声衰减(BUA)是一种用于研究骨状态的新技术。我们评估了其在骨质疏松症中的应用。为评估体内再现性,我们在50名女性的同一只脚上进行了五次测量(重新定位后),并据此确定了变异系数(cv)。cv为2.8±1.7%。右脚和左脚的BUA值相似,且与所研究的跟骨区域的骨密度相关(r = 0.8,p < 10⁻⁴)。在240名健康绝经后女性中,跟骨的BUA与腰椎、股骨和前臂的骨密度相关(相关系数为0.36至0.55;p < 10⁻⁴)。BUA随年龄下降,在绝经后的头几年下降更为明显。37名骨质疏松女性的平均宽带超声衰减(58.92±11.59 dB/MHz)低于对照组(66.10±15.29 dB/MHz,p = 0.04)。用于评估BUA在骨质疏松症和骨质减少症中的鉴别价值的受试者工作特征曲线下面积分别为0.79和0.72。BUA与脊柱密度之间的kappa一致性系数为0.59。这些数据表明,BUA不能替代骨密度测量。需要进行前瞻性研究以调查该技术在识别骨质疏松性骨折高危女性方面的潜在作用。