Blake G M, Fogelman I
Department of Nuclear Medicine, Guy's Hospital, London, United Kingdom.
Endocrinol Metab Clin North Am. 1998 Jun;27(2):267-88. doi: 10.1016/s0889-8529(05)70005-0.
Over the past decade, growing awareness of the impact of osteoporosis on the elderly population and the availability of new treatments to prevent fractures have stimulated the rapid development of new radiologic techniques to assist in diagnosis. With the ability to perform high precision measurements of bone mineral density (BMD) in the spine and hip, dual X-ray absorptiometry (DXA) is well suited to meet this latter need. However, there is continuing interest in smaller, cheaper systems for assessing the peripheral skeleton that include DXA scanning of the distal forearm and a variety of devices for performing quantitative ultrasound (QUS) measurements on bone. Alongside the new equipment, new guidelines have been developed to assist in the interpretation of bone densitometry studies and, following a report by a World Health Organization working group, osteoporosis is increasingly diagnosed on the basis of the patient's T-score value (difference of BMD from young adult mean normalized to the population SD). For the future, wider provision of bone densitometry services is required to properly target the new treatments now becoming available. Since it is unlikely that conventional DXA can meet these needs, QUS is an attractive alternative, especially because this technique is now proven in its ability to predict fracture risk in the elderly and FDA approval is imminent.
在过去十年中，人们越来越意识到骨质疏松症对老年人群的影响，以及预防骨折的新疗法的出现，这推动了有助于诊断的新放射技术的快速发展。双能X线吸收法（DXA）能够对脊柱和髋部的骨密度（BMD）进行高精度测量，非常适合满足后一种需求。然而，人们仍对用于评估外周骨骼的更小、更便宜的系统感兴趣，这些系统包括对远端前臂进行DXA扫描以及各种用于对骨骼进行定量超声（QUS）测量的设备。除了新设备外，还制定了新的指南来协助解读骨密度测量研究，并且在世界卫生组织一个工作组的报告之后，越来越多地根据患者的T值（BMD与年轻成人平均值的差异，按人群标准差进行标准化）来诊断骨质疏松症。未来，需要更广泛地提供骨密度测量服务，以便正确地针对现有的新疗法。由于传统的DXA不太可能满足这些需求，QUS是一个有吸引力的替代方法，特别是因为该技术现已被证明能够预测老年人的骨折风险，并且即将获得美国食品药品监督管理局的批准。
