Ubuninzi beeminerali zethambo lomqolo kunye ne-hip balinganiswa yi-DXA
Ukuchaneka kwe-DXA ekulinganiseni iindawo ezahlukeneyo ze-anatomical zomzimba womntu ziyahluka [4-7].Ukuchaneka kwe-DXA ekulinganiseni umqolo ngu-0.5% ~ 2%, kodwa ngokuqhelekileyo> 1%.Ukuchaneka kwe-hip yi-1% ~ 5%, kunye nentamo ye-femoral kunye ne-rotor enkulu (1% ~ 2%) iphezulu kunonxantathu weWadi (2.5% ~ 5%) (4. 6. 8).Ngaphandle komxholo ophezulu wethambo elirhoxisayo kunxantathu weWadi kunye novakalelo oluphezulu kwiinguqu kwi-BMD [9], ukuchaneka kwayo okungalunganga ngenxa yendawo yayo encinci yokubonisa kunye neempazamo zesampulu kunye nokuphindaphinda kunciphisa ukusetyenziswa kwayo kweklinikhi.Ukunciphisa impembelelo yesimo sokuskena ngokuchanekileyo xa usenza imilinganiselo ye-DXA, iinqumlo kunye namadolo aguquguqukayo kwinkxaso yokuvumela ukuba umqolo ube yinyani kwiqonga lokunciphisa i-lumbar lordosis ngexesha lokumiselwa kwe-BMD kwindawo ye-anteroposteric lumbar PA).Ngexesha lokuskena kwe-hip, ithanga lalixutywa kancinane kwaye lichazwe, kwaye ngoncedo lwesixhobo sokulungiswa kwe-postural, intamo ye-femoral yayibekwe ngokuhambelana netafile yokuskena ukuphepha ukunyusa i-BMD ngenxa yokunciphisa intamo ye-femoral (ukunciphisa umthamo ofanayo. umxholo weeminerali zamathambo).Ekumiselweni kwe-hip BMD nge-DXA, izikhundla ezahlukeneyo zomlenze zingabangela iimpazamo ezibalulekileyo, ukusuka kwi-0.9% ukuya kwi-4.5% yentamo ye-femal, i-1.0% ukuya kwi-6.7% ye-triangle ye-Ward, kunye ne-0.4% ukuya kwi-3.1% ye-trochanter enkulu [6].Ngoko ke, xa i-DXA ihlola i-hip, ukuma okuchanekileyo kuya kunciphisa kakhulu impazamo, eyona nto ibalulekileyo yokuqinisekisa i-Angle echanekileyo.
Ukuba iziphumo ze-hip BMD ezilinganiswe yi-DXA azihambelani nokubonakaliswa kweklinikhi, enye kufuneka yenziwe
Umbhali kufuneka ajonge ukuba indawo yokuskena ichanekile;Kwelinye icala, oogqirha kufuneka bathathele ingqalelo impembelelo yesimo sokuskena kwi-BMD.Ukongeza kwimpembelelo yesikhundla ekuchanekeni komlinganiselo weDXA, ezinye izizathu zinokuchaphazela iziphumo zokulinganisa.Ukulungelelaniswa komqolo kunqunywe yi-DXA.
I-BMD yomgogodla ichazwa njengobuninzi bendawo yonke yomzimba we-vertebral, kubandakanywa nomzimba we-vertebral kunye ne-arch (ithambo le-cortical ukuya kwi-cancellous bone ratio 50: 50), i-aortic calcification, i-osteoarthrosis eyohlayo, inkqubo ye-osteopanthogenic spinous, i-callus, kunye ne-compression fractures, yonke into. igalelo ekwandeni koxinaniso lwamathambo amaminerali.Nangona kunjalo, utshintsho oluguquguqukayo olufana ne-hyperosteoplasia luxhaphake kakhulu kubantu abadala abangaphezu kweminyaka engama-70 ubudala, kunye nokuxhaphaka okungaphezulu kwe-60%, okukhawulela ukusebenza kunye novakalelo lwe-DXA yokulinganisa i-orthotopic yomgogodla kubantu abadala.Isiganeko se-osteoporosis siphezulu kwaye sibi kakhulu kubantu abaphakathi kunye nabantu abadala
Sisifo esiqhelekileyo sobudala obusongela impilo yabantu abaneminyaka ephakathi kunye nabantu abadala.Ukuze kupheliswe impembelelo yale miba ingentla, uphuhliso lweteknoloji ye-DXA lumbar lateral scanning (1121, i-DXA yokuqala yokuskena enye i-lumbar scanning, isifo silungele ukugcina indawo yokuskena, eyona nto ibangela ukuba i-lumbar ibambe i-scan ye-lumbar.
Ukuchaneka kokuchaneka, okwakuyi-2.8% ukuya kwi-5.9%!
Ngexesha elifanayo kwezinye izifo
Abantu, ngakumbi abo bane-osteoporosis enzima, banobunzima bokujika.
Kwiminyaka yakutshanje, iskena se-DXA samkela umqadi omilise okwefeni ojikelezayo "C" ukuskena ingalo emile, evumela izifo.
Umqolo we-BMD ulinganiswe nge-anteroposterically kwindawo ye-supine kwaye i-C-arm scanner yajikeleza i-90 °.
Isigulane sinokulinganiswa nge-DXA kwindawo esecaleni yekholomu yodumo ngaphandle kokuhamba
Ukuchaneka kokulinganisa kwecala kwakuyi-1.6% kwizifundo eziqhelekileyo kunye ne-2% kwizigulane ezine-osteoporosis.Umlinganiselo ofanelekileyo we-lateral we-DXA kufuneka uhlalutye i-BMD ye-4 lumbar vertebrae (L1-L).Nangona kunjalo, i-L1 kunye ne-L4 inokugqunywa ngeembambo kwaye i-L4 ngokucacileyo igqitywe ngethambo le-pelvic.Kwezinye izigulana, yi-L3 BMD kuphela enokuhlalutywa.I-ROIS (ingingqi yomdla) inokufumaneka kumbindi womzimba we-vertebral otyebileyo kwithambo elirhoxisayo (ithambo le-cortical / cancellous bone ratio ye-10: 90), okwenza imilinganiselo ye-DXA ivakale ngakumbi kwiinguqu ze-BMD kwicala kunokuba kumbono wangaphambili. .I-Lateral DXA isetyenziswe kwizifundo eziphilileyo kunye ne-columnar osteoporosis (i-vertebral compression fractures)
Ucalucalulo phakathi kokulahleka kwethambo olubangelwa yi-corticosteroids lungcono kune-PA-DXA, ephucula ukukwazi ukwahlula i-vertebral fractures kwi-non-fractures [15].Nangona i-DXA yenze inkqubela phambili enkulu ekulinganiseni i-BMD yomgogodla.Nangona kunjalo, ngenxa ye-scoliosis, i-humpback enzima kunye ne-spinal segmenting engaqhelekanga [4,61], ukusebenza kwe-DXA scanning kunzima, okuchaphazela ukuchaneka kokuzimisela kwe-DXA kunye nokunciphisa ukusetyenziswa kwekliniki ye-DXA.Uphononongo olongezelelweyo lufunekayo ukuthelekisa i-BMD "ye-volumetric" (mg / cm3) ibalwa ngokudibanisa imilinganiselo ye-DXA yangaphambili kunye necala kunye nendlela ye-QCT.
Ukuzimisela kwe-forearm ye-BMD kunye nokubunjwa komzimba yi-DXA
I-DXA isetyenziswa ngakumbi ukumisela umphambili we-BM [17].Imilinganiselo ye-BMD yenziwa kwi-distal radius (i-cancellous predominance), phakathi kunye nephakathi, kunye ne-distal yesithathu yeradius (i-cortical predominance) kunye nesigulane esihlala kwisihlalo esisecaleni kweqonga lokuskena kunye ne-forearm ebekwe eqongeni kunye nesandla esisisigxina. eqongeni ngokujikeleza kwangaphambili.I-densitometry yethambo lomzimba wonke nayo inokwenziwa.Oku kubonelela ngothelekiso olucwangcisiweyo lwe-BMD yomzimba wonke kunye ne-BMD yendawo.Ukuhlalutya kunye nokuphonononga ubudlelwane phakathi kwe-BMD yenkqubo kunye ne-BMD yasekhaya, kunye nokufumanisa indawo enovakalelo ye-densitometry yamathambo, ukuze unike olona khetho lufanelekileyo koogqirha.Ukuchaneka komlinganiselo womzimba wonke we-BMD yi-3% ukuya kwi-8%.I-19] Ukuchaneka kwe-BMD ye-forearm yi-0.8% -13%.Ngenxa yokuba ukuchaneka kwe-DXA yomzimba wonke i-BMD ingaphantsi kuneyamanye amalungu, ithambo lincinci
Ukukhululeka ngokubanzi ayisiyiyo indawo ekhethwayo yokuskena ukuxilongwa.Iziphumo zokuskena umzimba wonke zahlalutywa yinkqubo yolwazi lwesoftware yezicubu ezifanelekileyo zomntu (imisipha ebhityileyo kunye nobunzima bamafutha), kwaye iziphumo zokumiselwa kokwakheka komzimba zifunyenwe yiDXA.Ulungelelwaniso phakathi kweziphumo zokumisela ukwakheka komzimba kunye nezinye iindlela zokulinganisa ubunzima obungathanga ngqo zazilungile.Yinkalo ebalulekileyo enokufundwa ngakumbi.
Ixesha lokuposa: Aug-10-2022