Blanckaert F, Cortet B, Coquerelle P, Flipo R M, Duquesnoy B, Marchandise X, Delcambre B
Rheumatology Department, Lille Teaching Hospital, France.
Rev Rhum Engl Ed. 1997 May;64(5):305-13.
We evaluated ultrasound propagation through the calcaneus using the Achilles Lunar unit in patients with postmenopausal or glucocorticoid-induced osteoporosis. Speed of sound, broadband ultrasound attenuation and a combination of these two parameters called stiffness were determined. Reproducibility was 0.23%, 2.6%, and 2.6% for these three parameters, respectively. Bone mineral density measured at the spine and femoral neck by absorptiometry was significantly correlated with all three ultrasound parameters in the women with postmenopausal osteoporosis (n = 47) and in the controls (n = 42). In the patients with glucocorticoid-induced osteoporosis (n = 35), only speed of sound was significantly correlated with the bone mineral density measurements. Mean values in the subjects with postmenopausal osteoporosis and in their age-matched controls were 1473 +/- 27.2 m/sec versus 1500.6 +/- 29.6 m/sec for speed of sound, 95.3 +/- 9.6 dB/Mhz versus 105.7 +/- 10.1 dB/Mhz for broadband ultrasound attenuation, and 56.1 +/- 13.2 versus 70.9 +/- 14.1 for stiffness, indicating a significant difference (P < 0.01). Z scores were -0.91, -1.1, -0.93, -0.97, and -1.05 for bone mineral density at the spine, bone mineral density at the femoral neck, speed of sound, broadband ultrasound attenuation and stiffness, respectively. Receiver Operating Characteristic curves showed that there were no statistically significant differences between the ultrasound parameters at the calcaneus and the absorptiometry measurements at the spine and femoral neck. Mean values in glucocorticoid-treated patients and age-matched controls were 1480 +/- 26.9 m/sec versus 1505.1 +/- 30.3 m/sec for speed of sound, 99.2/-11.4 dB/Mhz versus 105.9 +/- -10.2 dB/Mhz for broadband ultrasound attenuation, and 60.7 +/- 14 versus 72.1/14.5 for stiffness, again indicating a significant difference (P < or = 0.01). Z scores were -0.55, -0.65, -0.8, -0.67, and -0.78 for bone mineral density at the spine, bone mineral density at the femoral neck, speed of sound, broadband ultrasound attenuation and stiffness, respectively. Our data suggest that ultrasound parameters measured at the calcaneus are useful for evaluating postmenopausal and glucocorticoid-induced osteoporosis.
我们使用跟腱部的Lunar超声仪评估了绝经后或糖皮质激素诱导的骨质疏松症患者中超声在跟骨中的传播情况。测定了声速、宽带超声衰减以及这两个参数的组合——硬度。这三个参数的重现性分别为0.23%、2.6%和2.6%。通过骨密度仪测量的脊柱和股骨颈骨矿物质密度与绝经后骨质疏松症女性患者（n = 47）及对照组（n = 42）的所有三个超声参数均显著相关。在糖皮质激素诱导的骨质疏松症患者（n = 35）中，只有声速与骨矿物质密度测量值显著相关。绝经后骨质疏松症患者及其年龄匹配对照组的声速平均值分别为1473±27.2米/秒和1500.6±29.6米/秒，宽带超声衰减分别为95.3±9.6分贝/兆赫和105.7±10.1分贝/兆赫，硬度分别为56.1±13.2和70.9±14.1，表明存在显著差异（P < 0.01）。脊柱骨矿物质密度、股骨颈骨矿物质密度、声速、宽带超声衰减和硬度的Z值分别为 -0.91、-1.1、-0.93、-0.97和 -1.05。受试者工作特征曲线显示，跟骨处的超声参数与脊柱和股骨颈处的骨密度测量值之间无统计学显著差异。糖皮质激素治疗患者及其年龄匹配对照组的声速平均值分别为1480±26.9米/秒和1505.1±30.3米/秒，宽带超声衰减分别为99.2/-11.4分贝/兆赫和105.9± -10.2分贝/兆赫，硬度分别为60.7±14和72.1/14.5，再次表明存在显著差异（P≤0.01）。脊柱骨矿物质密度、股骨颈骨矿物质密度、声速、宽带超声衰减和硬度的Z值分别为 -0.55、-0.65、-0.8、-0.67和 -0.78。我们的数据表明，在跟骨处测量的超声参数可用于评估绝经后和糖皮质激素诱导的骨质疏松症。
