Dual-Energy X-Ray Absorptiometry Interpretation and Reporting in Children and Adolescents: The Revised 2013 ISCD Pediatric Official Positions
Dual-Energy X-Ray Absorptiometry Interpretation and Reporting in Children and Adolescents: The Revised 2013 ISCD Pediatric Official Positions
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DOI：
10.1016/j.jocd.2014.01.003
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发表时间：
2014-04-01
影响因子：
2.5
通讯作者：
Gordon, Catherine M.
中科院分区：
文献类型：
--
作者：
Crabtree, Nicola J.;Arabi, Asma;Gordon, Catherine M.
国际临床密度测定学会关于儿童密度测定结果报告的官方修订立场代表了当前的专家建议，以帮助医疗保健提供者确定应测量哪些骨骼部位，应进行哪些调整（如果有的话），使用的参考数据库以及双能X射线吸收测定报告中应包含的元素。推荐的扫描部位仍然是全身（不包括头部）和脊柱后前角。讨论了其他部位，如股骨近端、股骨远端外侧、椎体外侧评估和前臂，但仅推荐用于特定儿科人群。不同的方法来解释骨密度扫描在儿童身材矮小或生长迟缓。推荐使用骨矿物质表观密度和身高调整Z评分作为合适的尺寸调整技术。适当参考数据库的有效性和升级软件和硬件时要考虑的技术因素保持不变。列出了所有当代骨密度仪的更新参考数据集。对于临床实践，仍建议纳入相关人口统计学和健康信息、扫描技术细节、Z评分以及Z评分小于或等于-2.0标准差的“低骨量或骨密度”措辞。提供了发展官方职位的理由和证据。证据质量分级、建议强度和全球适用性的变化代表了当前证据的变化和/或用于验证2013年立场发展会议立场声明的专家小组成员的意见分歧。
The International Society for Clinical Densitometry Official Revised Positions on reporting of densitometry results in children represent current expert recommendations to assist health care providers determine which skeletal sites should be measured, which, if any, adjustments should be made, reference databases to be used, and the elements to include in a dual-energy X-ray absorptiometry report. The recommended scanning sites remain the total body less head and the posterior-anterior spine. Other sites such as the proximal femur, lateral distal femur, lateral vertebral assessment, and forearm are discussed but are only recommended for specific pediatric populations. Different methods of interpreting bone density scans in children with short stature or growth delay are presented. The use of bone mineral apparent density and height-adjusted Z-scores are recommended as suitable size adjustment techniques. The validity of appropriate reference databases and technical considerations to consider when upgrading software and hardware remain unchanged. Updated reference data sets for all contemporary bone densitometers are listed. The inclusion of relevant demographic and health information, technical details of the scan, Z-scores, and the wording "low bone mass or bone density" for Z-scores less than or equal to -2.0 standard deviation are still recommended for clinical practice. The rationale and evidence for the development of the Official Positions are provided. Changes in the grading of quality of evidence, strength of recommendation, and worldwide applicability represent a change in current evidence and/or differences in opinion of the expert panelists used to validate the position statements for the 2013 Position Development Conference.