Bone densitometry in the diagnosis of vertebral fractures in children:: Accuracy of vertebral fracture assessment
Bone densitometry in the diagnosis of vertebral fractures in children:: Accuracy of vertebral fracture assessment
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DOI：
10.1016/j.bone.2007.05.012
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发表时间：
2007-09-01
期刊：
影响因子：
4.1
通讯作者：
Makitie, Outi
中科院分区：
文献类型：
--
作者：
Mayranpaa, Mervi K.;Helenius, Ilkka;Makitie, Outi
背景：DXA扫描仪获得的脊柱图像用于成人椎体骨折检测。目前还不清楚这种方法是否可以用于儿科。本研究评价了DXA图像在儿童椎体骨折评估（VFA）中的诊断准确性。方法：本研究包括65名儿童（37名男性，中位年龄12.1岁）原发性或继发性骨质疏松症。从医院记录中收集临床病史数据。通过标准脊柱X线片和骨密度测定（Hologic Discovery A）衍生的VFA图像评估患者的脊柱压缩性骨折。VFA图像中每个椎骨的可见性和形态由两名阅片员和DXA扫描仪开发的半计算机化软件进行评估。结果：VFA图像在T8-L4椎体显示良好，但在上胸椎区（T4-T7）椎体显示较差，与标准X线片相比，VFA图像的椎体显示较差。X光片中总共诊断出25处椎骨骨折，但其中只有9处（36%）也在VFA图像中。半计算机化的软件不能准确地检测椎骨在大多数的儿童;准确性随着年龄的增加，身高和BMD，但不足以检测椎骨fractures.Conclusions：DXA扫描仪衍生的图像的脊椎在儿童椎骨骨折检测的效用是有限的妥协的能见度和诊断准确性差。半计算机化软件不适合儿科使用。在评估儿科患者的骨质疏松症时，应记住这些局限性。(C)2007年爱思唯尔公司All rights reserved.
Background: DXA scanner derived images of the spine are used for vertebral fracture detection in adults. It is unknown whether the method could be used in pediatrics. This study evaluated the diagnostic accuracy of DXA images in vertebral fracture assessment (VFA) in children.Methods: The study included 65 children (37 males; median age 12.1 years) with primary or secondary osteoporosis. Data on clinical history were collected from hospital records. Patients were assessed for spinal compression fractures by standard spinal radiographs and by bone densitometry (Hologic Discovery A) derived VFA images. The visibility and morphology of each vertebra in VFA images was assessed by two readers and by a semi-computerized software developed for the DXA scanner. The findings were compared with those in spinal radiographs and correlated with clinical parameters.Results: The visibility of vertebrae in VFA images was good in T8-L4 but compromised in the upper thoracic region (T4-T7) and was constantly inferior to that in standard radiographs. A total of 25 vertebral fractures were diagnosed in radiographs, but only 9 (36%) of these also in VFA images. The semi-computerized software could not accurately detect vertebrae in most of the children; accuracy increased with increasing age, height and BMD but was not sufficient to detect vertebral fractures.Conclusions: The utility of DXA scanner derived images of the spine in vertebral fracture detection in children is limited by compromised visibility and poor diagnostic accuracy. The semi-computerized software is not suitable for pediatric use. These limitations should be kept in mind when assessing pediatric patients for osteoporosis. (C) 2007 Elsevier Inc. All rights reserved.