腰椎侧位骨密度测量在骨质疏松症诊断中的应用

Detemination of lateral lunber spine in diagnose osteoporosis

目的 为了探讨腰椎前后位、腰椎侧位测量图象的分析方法 ,以便寻找更敏感的测量部位 ,为本地区骨质疏松症的研究提供有益的参考数据。方法 本研究应用法国DMS公司生产的Challanger双能X线骨密度仪 ,对大连地区 80 1名正常人的腰椎骨密度进行了测定。在图象分析上我们探讨了腰椎侧位图象的分析方法 ,即在ROI(regionsofinterest)的划定上 ,采用了腰椎侧位全椎体和腰椎侧位中间区两种划定方法 ,侧位中间区ROI大小规定为椎体扫描图象长宽各 1 /2所围的区域。结果 男性腰椎骨峰值年龄在 2 0～ 2 9岁 ;女性腰椎骨峰值年龄在 30～ 39。无论男性还是女性 ,腰椎骨量随年龄增长而丢失增加 ,腰椎各部位骨量累计丢失率顺序为 :腰椎侧位中间区 >腰椎侧位全椎体>腰椎前后位 ,腰椎侧位中间区最敏感。结论 男性腰椎各部位骨峰值年龄在 2 0～ 2 9岁 ;女性腰椎部位骨峰值年龄在 30～ 39。腰椎侧位BMD能更敏感地反映腰椎松质骨骨量的变化 ,以侧位中间区最敏感 。

Objective To study the method for analyzing the images of BMD measurement of posterior anterior and lateral lumbar spine, in an effort to find sensitive measuring sites, providing reference data for proevention and treatment of osteoporosis Methods Bone mineral density of the lumbar spine in 801 healthy subjects was measured with DMS Challanger dual energy X ray absorptiometer made in France For analysis of lateral lumbar spine images, the lateral lumbar vertebral body and midlateral lumbar spine were demarcated to set the area of ROI The ROI in midlateral lumbar spine was set as an area of half the length by half the width of the scanned vertebral body image Results The peak mass of BMD of lumbar vertebrae occurred in the 20 29 age group for males and in the 30 39 age group for females The rates of accumulative loss of BMD of lumbar veterbrae was accelerated with increasing age for both sexes, especially for females in age groups of 50 59and 60 69years, in the following order: midlateral>lateral>posterior anterior for males and fermales Conclusion The peak mass of BMD of lumbar vertebrae occurr in the 20 29 age group of males, in the 30 39age group of females The BMD of lateral lumbar vertebrae, especially midlateral lumbar vertebrae, is more sensitive than that of posterior anterior lumbar vertebrae