Morphometric X‐Ray Absorptiometry: Reference Data for Vertebral Dimensions
Morphometric X‐Ray Absorptiometry: Reference Data for Vertebral Dimensions
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DOI：
10.1359/jbmr.1998.13.3.464
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发表时间：
1998-03
影响因子：
6.2
通讯作者：
J. Rea;P. Steiger;G. Blake;E. Potts;I. Smith;I. Fogelman
中科院分区：
文献类型：
--
作者：
J. Rea;P. Steiger;G. Blake;E. Potts;I. Smith;I. Fogelman
椎体骨折是骨质疏松症常见而重要的后果，通常通过对传统的脊柱侧位X线片(形态测量X光片或MRX)的形态计量分析来确定。最近发展了一种利用双能X射线吸收(DXA)扫描仪获得的图像进行椎体形态测量的新方法(形态X射线吸收或MXA)。在这项研究中，我们使用MXA扫描作为数据源，得出椎体高度和高度比率的参考数据，并将结果与先前发表的MRX研究进行比较。招募了1,019名高加索女性(平均年龄63岁，范围33-86岁)。在位于英国三个中心的四个DXA系统中的一个上，对每个受试者进行了MXA扫描，覆盖了从L4到T4的13个椎体。方差分析发现，中心、机器和扫描模式之间的差异在统计学上显著，但相对较小，因此数据被汇集起来用于参考范围计算。测量了三个椎体高度(前、中、后)，并计算了四个比率(楔形、中间楔形和两个挤压)。使用迭代算法对这些数据集进行修剪，以去除假设代表椎骨变形的极值，然后使用剩余数据计算平均值和SD值。当数据按年龄划分时，发现在第六到八十年间椎体高度有小幅但在统计学上显著的下降，但在椎体高度比率上没有重复。在MXA数据和MRX之间观察到显著差异，但与不同MRX研究之间的结果相似。这可能是由于图像质量和点位方案的不同、人群的差异、放射学技术的差异以及一组“正常”椎骨来源的差异造成的。这项研究建议，脊柱尺寸的参考数据应该特定于使用这些数据作为参考的技术，即MXA。
Vertebral fractures are a common and important consequence of osteoporosis and are often identified via morphometric analysis of conventional lateral spine radiographs (morphometric radiography or MRX). A new method of performing vertebral morphometry using images acquired on dual‐energy X‐ray absorptiometry (DXA) scanners (morphometric X‐ray absorptiometry or MXA) has recently been developed. In this study, we derive reference data for vertebral heights and height ratios using MXA scans as the data source and compare the results with previously published MRX studies. One thousand and nineteen Caucasian women (mean age 63 years, range 33–86) were recruited. An MXA scan, covering 13 vertebrae from L4 to T4, was acquired for each subject on one of four DXA systems located at three centers in the U.K. Analysis of variance found statistically significant but relatively small differences among centers, machines, and scan modes, and therefore data were pooled for reference range calculations. Three vertebral heights (anterior, mid, and posterior) were measured and four ratios (wedge, mid‐wedge, and two crush) calculated. These data sets were trimmed using an iterative algorithm to remove extreme values assumed to represent deformed vertebrae, then mean and SD values were calculated using the remaining data. When the data were split by age, a small but statistically significant decrease in vertebral height between the sixth and eighth decades was found, but this was not replicated for the vertebral height ratios. Marked differences were observed between MXA data and MRX, but were comparable to those between different MRX studies. These may result from differences in image quality and point placement protocols, population differences, differences in radiographic technique, and differences in the derivation of a group of “normal” vertebrae. This study suggests that reference data of vertebral dimensions should be specific to the technique which uses those data as a reference, i.e., MXA.