测量腰椎、股骨近端骨密度中若干问题探究.docVIP

测量腰椎、股骨近端骨密度中若干问题探究 　 作者：崔霞,秦林林,刘鸿娥,李晓鸣,袁贺匀,颜珏 【关键词】 测量；股骨；骨密度 ［摘要］ 目的 通过应用双能X线骨密度仪（DXA）测量腰椎和股骨骨密度（BMD）中几个技术问题研究，指出在测量和分析结果时值得注意的几个问题。方法 比较同一患者选择标准束和薄型束扫描股骨近端结果的不同;对腰椎各椎体间T评分差＞1 SD，不同分析方法的差别;列举1例患者比较股骨颈感兴趣区微小变化对诊断结果的影响。结果 对瘦体型患者薄型束扫描骨边缘比标准束完整，各部位BMD值有增加，在大粗隆部位二者T评分相差最大可超过3 SD;正常人相邻椎体间T评分差＜SD，患者1 L3和L4相差2.2 SD，患者2 L2和L3相差1.3 SD，患者3 L2和L3相差1.5 SD，相邻椎体间差均＞1 SD;股骨颈感兴趣区中心位置在X轴线上从124变为120微小移动,股骨颈的T评分从-2.7 SD增至-2.4 SD。结论 正确测量和分析技术对获得可靠诊断结果至关重要，需要进一步认真研究。 ［关键词］ 测量；股骨；骨密度 Research on measurement technology of bone mineral density at lumber and hip ［Abstract］ Objective Through research on measurement technology of bone mineral density（BMD）at lumber and hip,point out some important technology in measurement and analysis.Methods The different result of scan at hip were compared using standard and thin X ray for patients.When T score different of close two lumbers were large than 1 SD,the different result was reported and reason was analyzed.When slight moving ROI position of neck,different results of BMD and T score at neck,trocant and total hip were compared.Results Bone edge was more clear and BMD of average parts at hip were larger when using thin X ray than standard X-ray for thin patients.T score different of close two lumbers was less 1SD for healthy subjects.T score different of L3 and L4 was 2.2SD for patient 1,T score different of L2 and L3 was 1.3 SD for patient 2.T score different of L2 and L3 was 1.5 SD for patient 3.ROI position at neck slight was moving from 120 to 124 of X axis.T score at neck was changed from -2.4 to -2.7 SD.Conclusion Correct measurement and analysis technology is very important for diagnosing osteoporosis,more technology key needed further discussed. ［Key words］ measurement;femur;bone mineral density 骨密度测量广泛应用在对骨折发生率的预测中，双能X线骨密度仪（DXA）是目前国际公认精确度高、扫描速度快的诊断骨质疏松测量仪［1］，常规测量腰椎、股骨近端两个部位。在骨密度测量中对患者的摆位和影像分析是测量技术中两个重要方面。不正确摆位和对图像的错误分析及报告会导致不正确的测量结果和错误的诊断［2］。本文对我院骨密度测量患者进行回顾性研究，指出在患者测量中易发生的几种错误，说明正确测量和分析技术的重要性，它是获得对骨质疏松诊断结果的基础保证。 1 资料与方法 1.1 一般资料