Mandibular radiomorphometric indices in the diagnosis of reduce skeletal bone mineral density
Mandibular radiomorphometric indices in the diagnosis of reduce skeletal bone mineral density
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DOI：
10.1007/s001980200042
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发表时间：
2002-01-01
影响因子：
4
通讯作者：
Horner, K
中科院分区：
文献类型：
--
作者：
Devlin, H;Horner, K
骨质疏松症的诊断允许提供预防和治疗干预，通常使用骨密度测定技术来实现。密度测定的一个参考标准是X线片上的骨质减少。本研究的目的是测量下颌骨皮质指数测量全景X线片在诊断骨骼骨密度降低的有效性。74名妇女进行了股骨颈，腰椎和前臂的骨密度测定。55例患者（74%）被归类为骨密度降低（T评分小于或等于-1）。27名患者在三个测量部位中的一个或多个观察到T评分< -2.5。对每位患者拍摄全景X线片，两名观察员测量颏孔（颏指数，MI）、前角（前角指数，AI）和前角（前角指数，GI）区域的皮质厚度。Logistic回归和受试者工作特征（ROC）曲线分析用于衡量皮质指数在骨密度降低诊断中的有效性。只有MI对低骨骼骨矿物质密度（T评分小于或等于-1）的诊断有显着贡献。两个观察者测量MI的95%一致性界限为1.32至+1.32 mm。当合并两个观察者的数据时，ROC曲线下面积为0.733（SE = 0.072; 95%置信区间= 0.618至0.83）。表示中等精度。建议将3 mm（或更小）的MI诊断阈值作为转诊进行骨密度测定的最合适阈值。然而，该研究仅为使用全景放射形态测量指数诊断低骨骼骨密度提供了有限的支持。他们可能，值得怀疑的是，被用作骨质疏松症风险评估方法的一部分。
Diagnosis of osteoporosis allows the delivery of preventive and therapeutic intervention and is usually achieved using bone densitometric techniques. One referral criterion for densitometry is osteopenia on radiographs. The aim of this study was to measure the validity of mandibular cortical indices measured on panoramic radiographs in the diagnosis of reduced skeletal bone density. Seventy-four women underwent bone densitometry of the femoral neck, lumbar spine and the forearm. Fifty-five patients (74%) were classified as having a reduced bone density (T-score less than or equal to-1). Twenty-seven patients had a T-score of < -2.5 observed at one or more of the three measurement sites. A panoramic radiograph was taken of each patient and two observers made measurements of cortical thickness at the mental foramen (mental index, MI), antegonion (antegonial index, AI) and gonion (gonial index, GI) regions. Logistic regression and receiver operating characteristic (ROC) curve analyses were used to measure the validity of cortical indices in the diagnosis of reduced bone mineral density. Only MI contributed significantly to a diagnosis of low skeletal bone mineral density (T-score less than or equal to-1). The 95% limits of agreement between observers in measurement of MI were 1.32 to +1.32 mm. When data for both observers were combined, the area under the ROC curve was 0.733 (SE = 0.072; 95% confidence interval = 0.618 to 0.83). indicating moderate accuracy. A diagnostic threshold for MI of 3 mm (or less) is suggested as the most appropriate threshold for referral for bone densitometry. However, the study provided only limited support for the use of panoramic radiomorphometric indices in diagnosing low skeletal bone mineral density. They might, questionably, be used as part of a method of osteoporosis risk assessment.