Panoramic radiographs and quantitative ultrasound of the radius and phalanx III to assess bone mineral status in postmenopausal women
Panoramic radiographs and quantitative ultrasound of the radius and phalanx III to assess bone mineral status in postmenopausal women
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DOI：
10.1186/s12903-018-0593-4
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发表时间：
2018-07-28
期刊：
影响因子：
2.9
通讯作者：
Lipski, Mariusz
中科院分区：
文献类型：
--
作者：
Grocholewicz, Katarzyna;Janiszewska-Olszowska, Joanna;Lipski, Mariusz
背景：各种下颌骨指数已被开发用于在曲面断层片上检测骨质疏松症。定量超声（QUS）是一种低成本、无辐射的骨状态评估方法。本研究的目的是比较桡骨和近节指骨III指的下颌骨形态测量分析和QUS。方法：本研究涉及97名绝经后女性，年龄48.5- 71.5岁（平均年龄：55.4岁）。下颌骨形态测量分析包括：颏孔后下颌骨上下缘之间的距离（H），颏孔-下颌骨下皮质的距离（IM）和颏区下颌骨皮质宽度（MCW）。然后计算比值：MCW/IM = PMI（全景下颌指数），H/IM = MR（下颌比值）。采用下颌骨皮质指数（MCI）对下颌骨皮质形态进行分类，采用QUS评估桡骨和近节指骨III指的骨矿状态，并与人群平均根尖骨量（T评分）进行比较，连续变量间的相关性采用线性回归分析，正态分布变量的相关系数采用Pearson相关系数r -。使用Student t检验比较正态分布变量，后者使用Mann-Whitney U检验。结果：下颌骨高度为13.42-34.42 mm，下颌骨皮质宽度平均为3.31 mm，PMI平均值为0.33，MR平均值为2.57。桡骨中Ad-SoS的平均值高于III指。指骨T评分值低于桡骨。22例患者桡骨T评分<-1.0，提示骨量减少。根据指骨T评分，39例患者出现骨质减少。下颌骨皮质指数C1级48例，C2 -级37例，C3 -级12例。老年女性下颌骨皮质指数得分较高。MCI与骨骼状况、H、MCW和MR显著相关（p= 0.01），而指骨T评分与PMI、MR和MCW无关。下颌骨皮质指数可作为骨质疏松症的筛查工具。2.第三节指骨的定量超声是评估骨状态的可靠方法。
Background: Various mandibular indices have been developed to detect osteoporosis on panoramic radiographs. Quantitative ultrasound (QUS) is a low-cost radiation-free method to assess bone status. The aim of this study was to compare mandibular morphometric analysis and QUS at the radius and proximal phalanx III finger.Methods: The study involved 97 postmenopausal women, aged 48.5-71.5y (mean: 55.4). Mandibular morphometric analysis comprised: distance between upper and lower mandibular borders just behind the mental foramen (H), distance: mental foramen - inferior mandibular cortex (IM) and mandibular cortical width at the mental region (MCW). Then, ratios were calculated: MCW/IM = PMI (panoramic mandibular index), H/IM = MR (mandibular ratio). Mandibular cortical index (MCI) was used to classify the morphology of the mandibular cortex.Bone mineral status assessed using QUS at the radius and proximal phalanx III finger was compared to population mean apical bone mass (T-score).Linear regression analysis was used for correlations between continuous variables, Pearson's correlation coefficient r - for variables of normal distribution. Student's t-test was used to compare variables of normal distribution and for the latter - Mann-Whitney U-test. The level of significance was p < 0.05.Results: Mandibular height was 13.42-34.42 mm. The mean mandibular cortical width was 3.31 mm. Mean values of PMI and MR were 0.33 and 2.57, respectively. Higher mean value of Ad-SoS was found in the radius than in the III finger. Phalanx T-score values were lower than those of the radius. T-score of the radius was < - 1.0 in 22 patients, indicating osteopenia. Basing on phalanx T-score, osteopenia was found in 39 patients. Category C1 of Mandibular Cortical Index was found in 48 women, C2 - in 37 women and C3 - in 12 women. Higher scores of Mandibular Cortical Index were recorded in older women. MCI significantly correlated with the skeletal status (p= 0.01) as well as with H, MCW and MR. Phalanx T-score was not correlated to PMI, MR or MCW.Conclusions: 1. Mandibular Cortical Index can be used as a screening tool for detecting osteoporosis. 2. Quantitative ultrasound at the phalanx III constitutes a reliable way of assessing bone status.