Hans D, Duboeuf F, Schott A M, Horn S, Avioli L V, Drezner M K, Meunier P J
Rheumatology & Bone Disease Department, INSERM U403, Edouard Herriot Hospital, Lyon, France.
J Bone Miner Res. 1997 Aug;12(8):1289-94. doi: 10.1359/jbmr.1997.12.8.1289.
In an attempt to reduce patient positioning errors, the authors tested the use of a new hip-specific positioning tool, OsteoDyne's Hip Positioner System (HPS). The HPS is an "A" frame splint designed to abduct both legs approximately 15 degrees to hold them in full extension at the hips and knees and to lock the feet in a neutral position. Seventy volunteer women aged 35-82 years were randomly assigned in two age-matched groups (mean age 56 years). Each group underwent two consecutive femur dual X-ray absorptiometry (DXA) scans with intermediate repositioning using the HPS system and two others utilizing the standard hip positioner provided with Hologic and Lunar scanners. One technician performed all scans using a Hologic QDR 1000-Plus and Lunar DPX-Plus densitometer. One hundred and fifty volunteer women aged 50-84 years (mean age, 64 years) were recruited in a multicenter study for the assessment of precision. Each subject underwent three consecutive femur DXA scans with intermediate repositioning using the HPS system. The coefficient of variation (CV) was significantly improved at the femoral neck by the use of the HPS with 0.7 versus 1.2 with the Hologic densitometer but only moderately altered at other sites. Similar results were found with the Lunar densitometer with improvement of precision at the femoral neck, 0.8 versus 1.8 with a similar trend but no significant difference at the other regions. No statistical difference was noted between the femoral neck BMD measured with the HPS system and with the standard positioners in either group. The mean precision of data obtained on the QDR 1000+ was 0.8% (range 0.1-1.4) for the femoral neck BMD, 1.1% (range 0.1-3.0) for the trochanter BMD, 2.3% (range 0.2-5.2) for Ward's triangle BMD, and 0.8% (range 0.1-1.9) for the total femur BMD. The mean precision of data obtained on the QDR 2000 was 0.7% (range 0.1-2), 1% (range 0.1-4.9), 2.6% (range 0.3-5.7), and 0.7% (range 0.1-1.8), respectively. In conclusion, data obtained with the new OsteoDyne's HPS seem capable of reducing patient positioning errors for the hip measurement. Its use is likely to improve confidence in hip bone mineral density measurements.
为了减少患者体位摆放错误，作者测试了一种新型的针对髋关节的定位工具——奥斯特迪恩（OsteoDyne）髋关节定位系统（HPS）。HPS是一个“A”形夹板，设计用于将双腿外展约15度，使髋关节和膝关节保持完全伸展，并将双脚锁定在中立位置。70名年龄在35至82岁之间的志愿者女性被随机分为两个年龄匹配组（平均年龄56岁）。每组使用HPS系统进行两次连续的股骨双能X线吸收测定法（DXA）扫描，并在中间进行重新定位，另外两次使用Hologic和Lunar扫描仪配备的标准髋关节定位器。一名技术人员使用Hologic QDR 1000 Plus和Lunar DPX Plus骨密度仪进行所有扫描。150名年龄在50至84岁之间（平均年龄64岁）的志愿者女性被招募参加一项多中心研究以评估精度。每个受试者使用HPS系统进行三次连续的股骨DXA扫描，并在中间进行重新定位。使用HPS时，股骨颈处的变异系数（CV）显著改善，使用Hologic骨密度仪时为0.7，而之前为1.2，但在其他部位仅略有改变。使用Lunar骨密度仪也得到了类似结果，股骨颈处的精度有所提高，分别为0.8和1.8，其他区域有类似趋势但无显著差异。两组中，使用HPS系统和标准定位器测量的股骨颈骨密度之间均未发现统计学差异。在QDR 1000+上获得的数据的平均精度，股骨颈骨密度为0.8%（范围0.1 - 1.4），大转子骨密度为1.1%（范围0.1 - 3.0），沃德三角区骨密度为2.3%（范围0.2 - 5.2），全股骨骨密度为0.8%（范围0.1 - 1.9）。在QDR 2000上获得的数据的平均精度分别为0.7%（范围0.1 - 2）、1%（范围0.1 - 4.9）、2.6%（范围0.3 - 5.7）和0.7%（范围0.1 - 1.8）。总之，使用新型奥斯特迪恩HPS获得的数据似乎能够减少髋关节测量时的患者体位摆放错误。其使用可能会提高对髋部骨密度测量的信心。
