DXA与QCT在骨质疏松诊断及预后监测中的应用

Application of DXA and QCT in Diagnosis and Prognosis Monitoring of Osteoporosis

骨质疏松症的特点为骨量减少和骨质量下降,导致骨折风险增加。定量成像方法对骨质疏松症的诊断及治疗效果随访至关重要。应用双能X线吸收法(DXA)测量骨密度作为定量参数是骨质疏松症诊断的金标准。因此,目前的临床决策在很大程度上依赖于对骨质疏松症影像特征的准确评估。新定量技术的开发使得定量CT(QCT)能评价骨质疏松症的骨三维结构。专用的高分辨率CT设备可以提高图像质量。CT或后处理设置对骨微结构和骨的几何形状(即一个骨的大小和形状的生物力学特性)有更详细的解析。未来,可在应用DXA诊断骨质疏松症的同时引入QCT技术,以同步评价患者骨骼的骨量和骨质量,从而为其治疗及随访提供更多信息。

Osteoporosis is characterized by decrease in bone volume and bone mass,resulting in an increased risk of fracture.The quantitative imaging method is of great importance to the diagnosis of osteoporosis and the follow-up of treatment effect.The method of dual-energy X-ray absorptiometry(DXA)used to measure the bone mineral density as a quantitative parameter is the gold standard for the diagnosis of osteoporosis.Therefore,the present clinical decision is largely dependent on an accurate evaluation of the image characteristics of osteoporosis.The development of new quantitative techniques has enabled quantitative CT(QCT)to evaluate the bone three-dimensional structure of osteoporosis.Special high resolution CT equipment can improve the image quality.CT or post-processing settings provide a more detailed analysis of bone microstructure and bone geometry(i.e.,the biomechanical properties of the size and shape of a bone).In the future,QCT technology can be introduced into the DXA diagnosis of osteoporosis,so as to simultaneously evaluate the bone volume and bone mass of the patients,and provide more information for treatment and follow-up.