股骨近端骨密度的测量

Measurement of bone mineral density at proximal femur by dual-energy X-ray absorptiometry

双能X线骨密度仪检测骨密度是诊断骨质疏松症和疗效随访的金标准,特别是髋部骨密度的测量对于骨折的预测尤其测定部位本身骨折的预测作用较大。由于脊柱部位的骨密度测量值易受到脊柱退行性疾病的病理改变如退行性侧凸、骨赘增生、腰椎间盘突出等影响,测量的准确性下降。因而近年来欧美国家临床试验也好或者骨质疏松诊疗也好,大都以股骨近端的BMD测定为标准。本文就股骨近端解剖特点、骨密度测量的意义、方法以及测量的注意点作一个综述,以期帮助临床医生或技术员全面评估股骨近端骨密度测定的意义。

Bone mineral density （BMD） measured by dual-energy X-ray absorptionmetry can be regarded as ＂gold standard＂ for the diagnosis and treatment follow-up. The measurement of BMD at proximal femur can not only predict an occurrence of the hip fracture but also in the other part of body fracture. The elderly population with high incidence of osteoporosis often combine with many degenerative disease, such as degenerative scoliosis, osteophyte formation, intervertebral disc herniation etc. These pathological changes in the lumbar spine might reduce the accuracy of BMD in anterposterior position. So the measurement of BMD at proximal femur become more and more popular in the clinical trial or diagnosis and treatment of osteoporosis in Europen and American areas in recently. This article reviews the anatomy characteristics of proximal femur, method and purport of measurement of BMD at proximal femur, and refers to some matters must be paid more attention in the procedures of measurement of BMD and facilitate clinicians and technicians to assess the clinical meaning of measurement of BMD at proximal femur comprehensively.