Ukuminyana kwamaminerali amathambo omgogodla nenyonga kukalwa nge-DXA
Ukunemba kwe-DXA ekulinganiseni izingxenye ze-anatomical ezihlukene zomzimba womuntu kuyehluka [4-7].Ukunemba kwe-DXA ekulinganiseni umgogodla ngu-0.5% ~ 2%, kodwa ngokuvamile > 1%.Ukunemba kwenyonga ngu-1% ~ 5%, intamo yesifazane kanye ne-rotor enkulu (1% ~ 2%) idlula unxantathu wesigceme (2.5% ~ 5%) (4. 6. 8).Naphezu kokuqukethwe okuphezulu kwethambo elikhansela kunxantathu Wesigceme kanye nokuzwela kwalo okuphezulu ezinguqukweni ze-BMD [9], ukunemba kwayo okungalungile ngenxa yendawo yayo encane yokuqagela kanye namaphutha esampula nokuphindaphinda kukhawulela ukusetshenziswa kwayo komtholampilo.Ukuze unciphise umthelela wesimo sokuskena ngokunemba lapho wenza izilinganiso ze-DXA, izinqe namadolo kwakuguquguquka ekusekeleni ukuvumela umgogodla ukuba ube yiqiniso endaweni yesikhulumi ukuze kuncishiswe i-lumbar lordosis ngesikhathi sokunqunywa kwe-BMD endaweni ye-anteroposteric lumbar (i-posteroposteric PA).Ngesikhathi sokuskena kwe-hip, ithanga lalithunjwa kancane futhi laphinyiselwa, futhi ngosizo lwedivayisi yokulungiswa kwe-postural, intamo ye-femoral yayibekwe ngokuhambisana netafula lokuskena ukuze kugwenywe ukwanda kwe-BMD ngenxa yokufinyezwa kwentamo yesifazane (ivolumu encishisiwe efanayo. okuqukethwe kwe-bone mineral).Ekunqumeni kwe-hip BMD nge-DXA, izikhundla ezihlukene zomlenze zingabangela amaphutha abalulekile, kusukela ku-0.9% kuya ku-4.5% entanyeni yesifazane, 1.0% kuya ku-6.7% kunxantathu weWard, kanye no-0.4% kuya ku-3.1% ku-trochanter enkulu [6].Ngakho-ke, lapho i-DXA iskena inqulu, ukuma okulungile kuzonciphisa kakhulu iphutha, okuyisihluthulelo sokuqinisekisa i-Angle enembile.
Uma imiphumela ye-hip BMD elinganiswa nge-DXA ingahambisani nokubonakaliswa komtholampilo, kufanele kwenziwe
Umbhali kufanele ahlole ukuthi indawo yokuskena ilungile yini;Ngakolunye uhlangothi, odokotela kufanele bacabangele umthelela wesimo sokuskena ku-BMD.Ngokungeziwe kumthelela wesikhundla ekunembeni kwesilinganiso se-DXA, ezinye izizathu zingase futhi zithinte imiphumela yokulinganisa.Ukuqondanisa umgogodla kunqunywe yi-DXA.
I-BMD yomgogodla ichazwa ngokuthi ukuminyana kwendawo yonke yomzimba we-vertebral, kuhlanganise nomzimba we-vertebral kanye ne-arch (ithambo le-cortical kuya ku-cancellous bone ratio 50: 50), ukubala kwe-aortic, i-osteoarthrosis ewohlokayo, inqubo ye-osteopanthogenic spinous, i-callus, kanye nokuhlukana kokucindezela, okuyinto yonke. nomthelela ekukhuleni kwamaminerali amathambo.Kodwa-ke, izinguquko eziwohlokayo ezifana ne-hyperosteoplasia zivame kakhulu kubantu asebekhulile abangaphezu kweminyaka engama-70 ubudala, ngokuvama okungaphezu kuka-60%, okukhawulela ukusebenza nokuzwela kwe-DXA yokulinganisa umgogodla we-orthotopic kubantu asebekhulile.Izehlakalo ze-osteoporosis ziphezulu futhi zibucayi kubantu abaneminyaka ephakathi nasebekhulile
Kuyisifo esivamile sokuguga esisongela impilo yabantu abaneminyaka ephakathi kanye nasebekhulile.Ukuze kuqedwe umthelela walezi zici ezingenhla, ukuthuthukiswa kobuchwepheshe be-DXA lumbar lateral scanning (1121, isithwebuli sokuqala se-DXA sokunye ukuskena kwe-lumbar, lesi sifo sithambekele ekugcineni isikhundla sokuskena, okuyinto
Kuthinte ukunemba, okwakungu-2.8% kuya ku-5.9%!
Ngesikhathi esifanayo kwezinye izifo
Abantu, ikakhulukazi labo abane-osteoporosis enzima, banenkinga yokuphenduka.
Eminyakeni yamuva nje, isithwebuli se-DXA samukela ukuskena kwengalo okumise okuka-"C" kwe-fan, okuvumela izifo.
I-BMD yomgogodla ikalwe i-anteroposterically endaweni engenhla futhi isithwebuli se-C-arm sazungeziswa ngo-90°
Isiguli singalinganiswa nge-DXA endaweni eseceleni yekholomu yesithunzi ngaphandle kokunyakaza
Ukunemba kokulinganisa kwe-lateral kwaba ngu-1.6% ezifundweni ezijwayelekile kanye no-2% ezigulini ezine-osteoporosis.Isilinganiso esifanele se-lateral DXA kufanele sihlaziye i-BMD ye-4 lumbar vertebrae (L1-L).Kodwa-ke, i-L1 ne-L4 ingase imbozwe izimbambo futhi i-L4 ngokusobala imbozwe ithambo le-pelvic.Kwezinye iziguli, i-L3 BMD kuphela engahlaziywa.I-ROIS(isifunda sentshisekelo) ingatholakala futhi phakathi nendawo yomzimba we-vertebral ecebile ngethambo elikhansela (i-cortical bone/cancellous bone ratio ye-10:90), okwenza izilinganiso ze-DXA zizwele kakhulu izinguquko ku-BMD ngaseceleni kunokubuka okungaphambili. .I-Lateral DXA isetshenziswa ezifundweni ezinempilo ezine-columnar osteoporosis (ama-vertebral compression fractures)
Ukubandlulula phakathi kokulahleka kwethambo okubangelwa i-corticosteroids kungcono kunaleyo ye-PA-DXA, ethuthukisa ikhono lokuhlukanisa ukuphuka kwama-vertebral kusuka ekungaqhekezini [15].Nakuba i-DXA yenze inqubekelaphambili enkulu ekulinganiseni i-BMD yomgogodla.Kodwa-ke, nge-scoliosis, i-humpback enzima kanye nokuhlukaniswa komgogodla okungavamile [4,61], ukusebenza kokuskena kwe-DXA kunzima, kuthinta ukunemba kokunqunywa kwe-DXA nokunciphisa ukusetshenziswa komtholampilo kwe-DXA.Kudingeka ucwaningo olwengeziwe ukuze kuqhathaniswe i-BMD “yevolumu” (mg/cm3) ebalwa ngezilinganiso ezihlanganisiwe ze-DXA zangaphambili nezingemuva ngendlela ye-QCT.
Ukunqunywa kwengalo yengalo ye-BMD nokwakheka komzimba nge-DXA
I-DXA isetshenziswa kakhulu ukunquma ingalo ye-BM[17].Izilinganiso ze-BMD zenziwa ku-distal radius (cancellous predominance), maphakathi naphakathi, kanye ne-distal third ye-radius (cortical predominance) nesiguli sihlezi esihlalweni esiseduze neplathifomu yokuskena nengalo ebekwe endaweni yesikhulumi futhi isandla simisiwe. endaweni yesikhulumi ngokuzungeza kwangaphambili.I-densitometry yethambo lomzimba wonke nayo ingenziwa.Lokhu kunikeza ukuqhathanisa okuhlelekile kwe-BMD yomzimba wonke kanye ne-BMD yendawo.Ukuhlaziya nokuhlola ubudlelwano phakathi kwe-BMD ye-systemic ne-BMD yendawo, futhi uthole indawo ebucayi ye-bone densitometry, ukuze unikeze odokotela ukukhetha okungcono kakhulu.Ukunemba kwesilinganiso se-BMD somzimba wonke singama-3% kuya ku-8%.19] Ukunemba kwengalo yengalo ye-BMD ngu-0.8% -13%.Ngenxa yokuthi ukunemba kwe-DXA yomzimba wonke i-BMD incane kunezinye izingxenye, ithambo lincane
I-Lose ngokuvamile akuyona indawo yokuskena ekhethwayo yokuxilongwa.Imiphumela yokuskena umzimba wonke yahlaziywa ngohlelo lolwazi lwesofthiwe lwezicubu zomuntu ezifanele (imisipha ethambile nesisindo samafutha), futhi imiphumela yokunqunywa kokwakheka komzimba yatholwa yi-DXA.Ukuhlobana phakathi kwemiphumela yokunqunywa kokwakheka komzimba nezinye izindlela zokulinganisa isisindo esingaqondile kwakukuhle.Kuwumkhakha obalulekile ongaqhutshekwa nokufunda ngawo.
Isikhathi sokuthumela: Aug-10-2022