Dual X-ray absorptiometry T-score concordance and discordance between hip and spine measurement sites
Dual X-ray absorptiometry T-score concordance and discordance between hip and spine measurement sites
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DOI：
10.1385/jcd:3:4:319
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发表时间：
2000-12-01
影响因子：
2.5
通讯作者：
Woodson, G
中科院分区：
文献类型：
--
作者：
Woodson, G
当髋关节和脊柱之间的差异足以导致两个测量部位落入世界卫生组织（WHO）分类系统定义的两种不同诊断时，观察到T评分不一致。本文研究了1989年至1999年在社区门诊骨质疏松症检测中心接受双能X线吸收法（DXA）骨密度检测的5051例女性患者中，全髋关节和PA L1-L4全脊柱测量结果之间T评分不一致模式的患病率。将所有患者的数据存储在关系数据库中，检索T评分的各种组合，反映正常、骨质减少和骨质疏松症的9种可能的不一致和一致排列。世界卫生组织骨质疏松症诊断分类系统将患者分为三种诊断-正常，骨质减少或骨质疏松-并基于他们的T评分。该系统用于确定PA L1-L4腰椎和全髋关节的各种T评分结果的患者诊断。当脊柱和髋关节T评分将患者置于相同的诊断分类时，一致性被定义为存在。当两个研究中心之间的差异不超过一个WHO诊断分类时，将轻微不一致定义为存在。严重不一致定义为当一个部位出现增生而另一个部位正常时存在。结果表明，髋关节与脊柱的T评分一致率为56%，轻微不一致率为39%，严重不一致率为5%，并将不一致分为生理性、病理生理性、解剖性、人为性和技术性5种病因。总之，该数据分析表明，虽然T评分一致性是最常见的，但在脊柱和髋关节部位之间进行DXA测试的每五名患者中约有两名患者存在轻微的不一致性。主要不一致是罕见的，每20例患者中只有1例被发现。
T-score discordance is observed when the difference between the hip and spine are sufficient to result in the two measurement sites falling into two different diagnoses as defined by the World Health Organization (WHO) classification system. This article examines the prevalence of patterns of T-score discordance between the total hip and PA L1-L4 total spine measurement sires in 5051 female patients undergoing dual X-ray absorptiometry (DXA) bone density testing at a community-based outpatient osteoporosis testing center between 1989 and 1999. Data for all patients were stored in a relational database that was searched for various combinations of T-scores reflecting the nine possible discordant and concordant permutations of normal, osteopenia, and osteoporosis. The WHO diagnostic classification system for osteoporosis categorizes patients into three diagnoses-normal, osteopenia, or osteoporosis-and is based on their T-score. This system was used to determine the patient diagnoses for the various T-score results in the PA L1-L4 lumbar spine and total hip. Concordance was defined as present when the spine and hip T-score placed the patient in the same diagnostic class. Minor discordance was defined as present when the difference between two sites is no more than one WHO diagnostic class. Major discordance was defined as present when one site is osteoporotic and the other site is normal. The results showed that in 56% of the cases the T-score concordance was present between the hip and the spine, 39% of the rime minor discordance was observed, and 5% of the time major discordance was found. Discordance was also classified into five etiologic types: physiologic, pathophysiologic, anatomic, artifactual, and technical. In summary, this data analysis showed that while T-score concordance is most commonly observed, minor discordance is seen in about two of every five patients tested with DXA between the spine and hip sites. Major discordance was uncommon, found in only 1 of every 20 patients tested.