坐位和仰卧位扫描姿势对DXA测量双侧前臂骨密度结果影响的研究

发布时间：2018-04-09 12:47

本文选题：骨密度　切入点：质量保证　出处：《北京协和医学院》2012年博士论文

【摘要】：研究目的：分析研究期间双能X线吸收仪(Dual-energy X-ray Absoptiometry, DXA)扫描骨密度的质量控制(quality control, QC)情况。材料和方法：所用机型为GE Lunar Prodigy,用校准块来完成质量保证(quality assurance, QA)测试,每日在测量患者之前完成一次QA测试；每日测量GE-Lunar腰椎体模,作Shewhart图,监测仪器纵向重复稳定性。由同一操作者进行扫描和分析。结果： 2010年7月至8月课题研究期间,每日测量自愿者之前都完成了QA测试。在2010-1-7到2010-11-12期间,校准体模骨密度(bone mineral desnity, BMD)、脂肪组织量、正常组织量、肌量的每日测定值均位于基线附近,呈直线分布。 2009-11-1到2010-11-12期间,腰椎体模BMD测量平均值为1.196g/cm2,每日测量值无明显漂移或移位。结论：骨密度测量中心DXA质量控制为前臂BMD数据获取提供了可靠性。目的：研究在坐位和仰卧位两种扫描姿势下DXA测量双侧前臂骨密度(bone mineral density, BMD)的测量精确性,并比较两种扫描姿势下双侧前臂BMD、骨量(bone mineral content, BMC)(?)各感兴趣区域(Region of Interest, ROI)的测量面积(Area)之间是否存在差异,分析前臂各ROI处BMD和腰椎、髋关节BMD的相关性情况。材料和方法：30名优势前臂均为右侧前臂的健康自愿者纳入本研究。用GE Lunar Prodigy分别测量自愿者在仰卧位下腰椎、髋关节和双侧前臂处BMD,并测量在坐位扫描姿势下双侧前臂BMD。每名自愿者BMD均在同一天内重新摆位后进行测量。结果： (1)在采用坐位和仰卧位的两种扫描姿势下,双侧前臂BMD测量精确性结果范围为0.99%-2.55%,BMC精确性范围为1.44-2.11%,测量面积(Area)精确性范围为1.15-2.73%； (2)采用坐位扫描姿势时,优势前臂除桡骨远端外,其余各感兴趣区域(ROI)的BMD、 BMC值均高于非优势侧(p0.05),优势侧前臂各ROI测量面积与非优势侧相比无差异(p0.05)；在仰卧位姿势扫描姿势时,优势前臂除桡骨远端外,其余ROIs的BMD、BMC值均高于非优势侧,优势侧前臂各ROI测量面积与非优势侧相比无差异(p0.05)； (3)在仰卧位扫描姿势下,左侧前臂除桡骨远端外各感兴趣区域BMD、BMC和坐位扫描姿势下相应左侧前臂BMD、BMC有差异(p0.05),在仰卧位扫描姿势下左侧前臂BMD、 BMC值低于坐位扫描姿势下所测值,但两种扫描姿势下测量面积无差异；同样,仰卧位扫描姿势下右侧前臂除桡骨远端外各感兴趣区域BMD、BMC低于相应右侧前臂感兴趣区域坐位扫描BMD、BMC(p0.05),但测量面积二者无差异； (4)在两种扫描姿势下双侧前臂桡骨远端BMD分别和腰椎、股骨颈、Ward's、Troch和Total处BMD相关；双侧桡骨全部、双侧前臂桡骨+尺骨全部处BMD分别和股骨颈、Troch和Total处BMD相关。结论：优势侧利非优势侧前臂BMD存在差别,这种差别在坐位和仰卧位扫描姿势下都存在；采用仰卧位扫描姿势测量前臂BMD会影响测量结果。
[Abstract]:Objectives of the study:The quality control (QCc) of bone mineral density (BMD) was analyzed by Dual-energy X-ray Absoptiometry (DXA).Materials and methods:The model was GE Lunar prodigy.The calibration block was used to complete the quality assurance test (QA), the QA test was completed daily before the patient was measured, the GE-Lunar lumbar vertebra model was measured daily, the Shewhart diagram was made, and the longitudinal repetitive stability of the instrument was monitored.Scanning and analysis by the same operator.Results:During the July-August 2010 study, QA tests were completed before the volunteers were measured daily.During the period from 2010-1-7 to 2010-11-12, the daily measured values of bone mineral desnity, BMD, adipose tissue volume, normal tissue volume and muscle volume were all located near the baseline and showed a linear distribution.From 2009-11-1 to 2010-11-12, the average value of BMD was 1.196g / cm ~ (-2).Conclusion:DXA quality control provides reliability for BMD data acquisition in forearm.Objective: to study the accuracy of DXA measurement of bone mineral density (BMD) of bilateral forearms in two scanning postures in sitting position and supine position.Whether there is a difference between the measured area of region of interest (ROI) or not, the correlation between BMD at ROI of forearm and BMD of lumbar spine and hip joint was analyzed.Materials and methods: 30 healthy volunteers with the right forearm were enrolled in the study.GE Lunar Prodigy was used to measure the BMDs of lumbar spine, hip joint and bilateral forearms in supine position, and to measure the BMDs of both forearms in the sitting position.Each volunteer BMD was measured after repositioning within the same day.Results:(1) in the two scanning postures of sitting position and supine position, the range of accuracy of bilateral forearm BMD was 0.99-2.55 and 1.44-2.11, and the accuracy range of area area was 1.15-2.73.(2) in the sitting position scanning posture, the BMC values of the dominant forearm, except the distal radius, were higher than those of the non-dominant side (p 0.05). The area measured by the ROI of the dominant forearm was not different from that of the non-dominant side (p 0.05), while in the supine position, there was no significant difference in the ROI measurement area between the dominant forearm and the non-dominant side, while in the supine position, there was no significant difference in the ROI measurement area between the dominant forearm and the non-dominant side.The BMD-BMC values of the dominant forearm were higher than those of the non-dominant side except for the distal radius. There was no significant difference in the area measured by ROI between the dominant forearm and the non-dominant side (p0.05).However, there was no difference in the area measured under the two scanning postures, but the BMD-BMC in the right forearm was lower than that in the right forearm, except for the distal radius, but there was no difference in the measured area between the right forearm and the right forearm in the sitting position, but there was no difference in the measured area between the two groups.(4) BMD of distal radius of bilateral forearm was correlated with BMD of lumbar vertebrae, femoral neck and Total under two scanning postures, and BMD of bilateral radius and ulna of forearm were correlated with BMD of femoral neck and Total, respectively.Conclusion: there are differences in BMD between the dominant and non-dominant forearms, which exist in the sitting position and supine position, and the measurement of BMD in the forearm by supine position will affect the measurement results.
【学位授予单位】：北京协和医学院
【学位级别】：博士
【学位授予年份】：2012
【分类号】：R816.8

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