Bone mineral density yemusana uye muhudyu yakayerwa neDXA
Kurongeka kweDXA pakuyera zvikamu zvakasiyana zveanatomical zvemuviri wemunhu zvinosiyana [4-7].Kurongeka kweDXA pakuyera musana ndeye 0.5% ~ 2%, asi kazhinji> 1%.Kururama kwehudyu ndeye 1% ~ 5%, nemutsipa wechikadzi uye guru rotor (1% ~ 2%) rinopfuura katatu reWard (2.5% ~ 5%) (4. 6. 8).Zvisinei nehupamhi hwehupfupa hwekanzura muWard's triangle uye nekunzwa kwayo kukuru kune shanduko muBMD [9], kusarongeka kwayo nekuda kwenzvimbo yayo diki yekufungidzira uye zvikanganiso zvesampling uye kudzokorora zvinodzikisira kushanda kwayo kwekiriniki.Kuti kuderedze kukanganiswa kwenzvimbo yekuongorora pamusoro pekururama pakuita zviyero zveDXA, mahudyu nemabvi zvakagadziriswa parutsigiro kubvumira musana kuti uve wechokwadi papuratifomu kuderedza lumbar lordosis panguva yekutsunga kweBMD mune anteroposteric lumbar position (postoposteric). PA).Munguva yekuongorora kwehudyu, chidya chakanga chakatorwa zvishoma uye chichitaurirwa, uye nerubatsiro rwechigadziro chekugadzirisa postural, mutsipa wechikadzi wakaiswa wakafanana netafura yekuongorora kuti urege kuwedzera BMD nekuda kwekupfupisa kwemutsipa wemukadzi (kuderedzwa kwevhoriyamu yakafanana. bone mineral content).Mukutsunga kwehudyu BMD neDXA, nzvimbo dzakasiyana dzemakumbo dzinogona kukonzera kukanganisa kukuru, kubva pa0.9% kusvika ku4.5% yehudyu yemutsipa, 1.0% kusvika 6.7% yeWard's triangle, uye 0.4% kusvika 3.1% ye trochanter yakakura [6].Naizvozvo, kana DXA ichitarisa hudyu, kumira kwakaringana kunoderedza zvakanyanya kukanganisa, inova kiyi yekuve nechokwadi chechokwadi cheAngle.
Kana mhedzisiro yehudyu BMD yakayerwa neDXA isingaenderane nekuratidzwa kwekiriniki, imwe inofanira kuitwa
Munyori anofanirwa kutarisa kuti nzvimbo yekuongorora ndeyechokwadi here;Kune rimwe divi, varapi vanofanirwa kufunga nezve pesvedzero yekutarisa chinzvimbo paBMD.Pamusoro pekupesvedzera kwechinzvimbo pakurongeka kwechiyero cheDXA, zvimwe zvikonzero zvinogona kukanganisa mhedzisiro yekuyera.Kurongeka kwemusana kwakatemwa neDXA.
Spinal BMD inotsanangurwa sekuwanda kweiyo vertebral body area, kusanganisira vertebral body uye arch (cortical bone to cancellous bone ratio 50:50), aortic calcification, degenerative osteoarthrosis, osteopanthogenic spinous process, callus, uye compression fractures, izvo zvese. kunobatsira kuwedzera bhonzo mineral density.Zvisinei, kuchinja kwekusagadzikana kwakadai se hyperosteoplasia kwakajairika kune vakwegura pamusoro pemakore makumi manomwe ekuberekwa, nekuwanda kweanopfuura 60%, izvo zvinoderedza kushanda uye kunzwisisika kweDXA musana orthotopic kuyerwa muhuwandu hwevanhu vakwegura.Chiitiko cheosteoporosis chakakwira uye chakakomba muzera repakati uye vanhu vakura
Icho chirwere chakajairika chekukwegura chinotyisidzira hutano hwepakati-kati uye vanhu vakwegura.Kuti abvise kupesvedzera kwezvinhu zviri pamusoro apa, kugadzirwa kweDXA lumbar lateral scanning tekinoroji (1121, yekutanga DXA scanner yeimwe lumbar scanning, chirwere chinowanzo chengetedza chinzvimbo chekuongorora, icho chiri.
Yakakanganisa kurongeka, yaive 2.8% kusvika 5.9%!
Panguva imwe chete kune zvimwe zvirwere
Vanhu, kunyanya avo vane osteoporosis yakaoma, vane dambudziko rekutendeuka.
Mumakore achangopfuura, DXA scanner inotora danda rakaita sefan rinotenderedza "C" ruoko rwekuvheneka ruoko, zvichibvumira chirwere.
Iyo musana BMD yakayerwa anteroposterically munzvimbo yepamusoro uye C-arm scanner yakatenderedzwa 90 °.
Murwere anogona kuyerwa neDXA munzvimbo yelateral yekolamu yekurumbira pasina kufamba
Kururama kwekuyera kwemashure kwaive 1.6% muzvidzidzo zvakajairika uye 2% kune varwere vane osteoporosis.Iyo yakakodzera lateral DXA kuyerwa kunofanirwa kuongorora iyo BMD ye4 lumbar vertebrae (L1-L).Nekudaro, L1 neL4 inogona kuvharwa nembabvu uye L4 iri pachena yakaputirwa nefupa rechiuno.Kune vamwe varwere, L3 BMD chete ndiyo inogona kuongororwa.Iyo ROIS (nzvimbo yekufarira) inogona zvakare kuwanikwa pakati peiyo vertebral muviri wakapfuma mu cancellous bone (cortical bone / cancellous bone ratio ye10: 90), zvichiita kuti DXA zviyero zvakanyanya kutarisisa shanduko muBMD mune lateral pane pamberi pekuona. .Lateral DXA inoshandiswa mune zvine hutano zvidzidzo zvine columnar osteoporosis (vertebral compression fractures)
Kusarura pakati pekurasikirwa kwemafupa kunokonzerwa necorticosteroids kuri nani pane yePA-DXA, iyo inovandudza kukwanisa kusiyanisa vertebral fractures kubva kune zvisiri-fractures [15].Kunyangwe DXA yakafambira mberi zvikuru mukuyera musana BMD.Zvisinei, kune scoliosis, humpback yakaoma uye kusagadzikana kwemusana wemusana [4,61], kushanda kweDXA scanning kwakaoma, kunokanganisa kurongeka kweDXA kutsunga uye kuderedza kushandiswa kwekliniki yeDXA.Zvimwe zvidzidzo zvinodiwa kuenzanisa iyo "volumetric" BMD (mg/cm3) yakaverengerwa neyakasanganiswa yemberi uye yakatarisana DXA zviyero nenzira yeQCT.
Kutsunga kwe forearm BMD uye kuumbwa kwemuviri neDXA
DXA iri kuwedzera kushandiswa kuona forearm BM [17].Zviyero zveBMD zvakaitwa mu distal radius (cancellous predominance), pakati nepakati, uye distal yechitatu yeradius (cortical predominance) nemurwere akagara pachigaro chiri pedyo nepuratifomu yekuongorora neruoko rwakamira pachikuva uye ruoko rwakagadzika. pachikuva nekutenderera kwepamberi.Muviri wese bhonzo densitometry inogonawo kuitwa.Izvi zvinopa kuenzanisa kwakarongeka kwemuviri-wese BMD uye BMD yemuno.Kuongorora nekuongorora hukama huripo pakati pesystemic BMD neBMD yemuno, uye nekutsvaga nzvimbo inonzwisa tsitsi yebhonzo densitometry, kuti ipe sarudzo yakanaka kuvarapi.Kurongeka kweyero yeBMD yemuviri wese ndeye 3% kusvika 8%.19] Kurongeka kweiyo forearm BMD ndeye 0.8% -13%.Nekuti chokwadi cheDXA muviri wese BMD ishoma pane yezvimwe zvikamu, bhonzo rakatetepa
Loose kazhinji haisi iyo yakasarudzika scan site yekuongororwa.Mhedzisiro yekuongorora kwemuviri wese yakaongororwa nesoftware ruzivo system yeakakodzera matissue emunhu (akaonda mhasuru uye mafuta mashoma), uye mhedzisiro yekumisikidzwa kwemuviri yakawanikwa neDXA.Iko kuwirirana pakati pemigumisiro yekugadzirisa kuumbwa kwemuviri uye dzimwe nzira dzisina kunanga dzekuyera uremu hwaive hwakanaka.Indima yakakosha iyo inogona kuwedzeredzwa kudzidza.
Nguva yekutumira: Aug-10-2022