Diacinti D, Acca M, Tomei E
Servizio di Radiologia, II Clinica Medica, Università La Sapienza, Roma.
Radiol Med. 1996 Jan-Feb;91(1-2):13-7.
The radiologic identification of vertebral fractures is usually subjective and reproducibility is poor. This paper describes a new digital radiologic method to perform vertebral morphometry, i.e. osteoradiometry (ORM). Lateral radiographs of the thoracic and lumbar spine were obtained in 50 premenopausal women and digitalized by means of a video camera. A special computer software enables to calculate the anterior (Ha), middle (Hm), and posterior (Hp) heights of vertebral bodies (T4-L5) and the morphometric indices of vertebral fractures. ORM reproducibility was assessed by comparing repeated measurements made by two radiologists: the intra- and interobserver variation coefficients (CV) were respectively 1.5% and 2.3% for Hp; 1.3% and 2% for Hm; 1.4% and 2.1% for Ha. The normal range for vertebral dimensions was therefore established. The anterior and posterior heights increased from T4 to L2, but for L3-L5 the posterior height was lower than the anterior height (Ha/Hp > 1). Vertebral heights positively correlated with the standing heights of the subjects (r = 0.2, p < 0.05). Weight and the body mass index (BMI) were not correlated with vertebral heights. These normal values, compared with those found in osteoporosis patients, will allow to assess ORM diagnostic efficacy in identifying vertebral fractures.
椎体骨折的放射学诊断通常具有主观性，且可重复性较差。本文描述了一种用于进行椎体形态测量的新型数字放射学方法，即骨放射测量法（ORM）。对50名绝经前女性的胸腰椎进行侧位X线摄片，并通过摄像机进行数字化处理。一种特殊的计算机软件能够计算椎体（T4-L5）的前部（Ha）、中部（Hm）和后部（Hp）高度以及椎体骨折的形态测量指标。通过比较两名放射科医生的重复测量结果来评估ORM的可重复性：Hp的观察者内和观察者间变异系数（CV）分别为1.5%和2.3%；Hm为1.3%和2%；Ha为1.4%和2.1%。由此确定了椎体尺寸的正常范围。前部和后部高度从T4到L2逐渐增加，但对于L3-L5，后部高度低于前部高度（Ha/Hp > 1）。椎体高度与受试者的身高呈正相关（r = 0.2，p < 0.05）。体重和体重指数（BMI）与椎体高度无关。将这些正常值与骨质疏松症患者的正常值进行比较，将有助于评估ORM在识别椎体骨折方面的诊断效能。
