Bone density in children: a review of the available techniques and indications
Bone density in children: a review of the available techniques and indications
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DOI：
10.1016/s0720-048x(97)00093-4
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发表时间：
1998-01-01
影响因子：
3.3
通讯作者：
Gilsanz, V
中科院分区：
文献类型：
--
作者：
Gilsanz, V
最近发展的测量儿童骨矿物质含量的方法显著提高了我们确定生长过程中骨量变化的能力。目前，测量儿童骨骼最普遍接受的三种技术是双能x射线吸收仪（DXA）、定量计算机断层扫描（QCT）和定量超声（QUS）。这些技术在获取数据方面差别很大，很难在它们之间进行比较，而且对它们的价值的判断往往至少部分是主观的。到目前为止，DXA是最广泛使用的骨测量技术。它成本低，易于获得，易于使用，并提供成人骨量的准确和精确的定量。不幸的是，DXA无法解释生长过程中身体和骨骼尺寸的巨大变化，限制了其在儿童纵向研究中的应用。QCT可以评估轴骨和尾骨的体积和密度，而不受身体或骨骼大小的影响，这使它比其他儿童骨骼测量方式具有主要优势。然而，CT扫描仪的成本和难以获得性极大地限制了其在骨骼测量中的应用。通过QUS测量儿童骨骼很有吸引力，因为超声波成本低，携带方便，使用方便，而且不发射辐射。在成人中，这项技术能够独立于骨质疏松患者的骨量测定来预测骨折风险，因此，它的测量必须与骨强度的某些方面有关。然而，超声值依赖于这么多；结构属性尚未完全理解，难以在儿童中有意义地使用信息。(C) 1998爱思唯尔科学爱尔兰有限公司
The recent development of methods for measuring bone mineral content in children has markedly improved our ability to determine changes in bone mass during growth. Currently, the three most generally accepted techniques for measuring the bones of children are dual-energy X-ray absorbtiometry (DXA), quantitative computed tomography (QCT) and quantitative ultrasound (QUS). These techniques vary considerably in their acquisition of data and comparisons between them are difficult and, more often than not, judgment regarding their value has been, at least partially, subjective. DXA is, by far, the most widely used technique for bone measurements. It is low in cost, accessible, easy to use, and provides an accurate and precise quantitation of bone mass in adults. Unfortunately, DXA is unable to account for the large changes in body and skeletal size that occur during growth, limiting its use in longitudinal studies in children. QCT can asses both the volume and the density of bone in the axial and appendicular skeletons, without influence from body or skeletal size, giving it a major advantage over other modalities for bone measurements in children. The cost and inaccessibility of CT scanners, however, has significantly limited its use for bone measurements. Measuring the bones of children by QUS is appealing because ultrasound is low in cost, portable, easy to use and does not emit radiation. In adults, this technique is able to predict fracture risk independent of bone mass determinations in patients with osteoporosis and, therefore, its measurements must be related to certain aspects of bone strength. However, ultrasound values are dependent on so many;structural properties not yet fully understood, that it is difficult to use the information meaningfully in children. (C) 1998 Elsevier Science Ireland Ltd.