The clinical use of quantitative ultra-sound (QUS) in the detection and management of osteoporosis
The clinical use of quantitative ultra-sound (QUS) in the detection and management of osteoporosis
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DOI：
10.1109/tuffc.2008.829
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发表时间：
2008-07-01
影响因子：
3.6
通讯作者：
Krieg, Marc-Antoine
中科院分区：
文献类型：
--
作者：
Hans, Didier;Krieg, Marc-Antoine
对于骨质疏松症和骨质疏松症相关骨折的检测和管理，定量超声（QUS）正在成为一种相对低成本和易于获得的替代双能X射线吸收法（DXA）测量骨矿物质密度（BMD）在某些情况下。以下是关于在6种情况下使用QUS的现有文献的简要但全面的综述：1）评估脆性骨折风险; 2）诊断骨质疏松症; 3）开始骨质疏松症治疗; 4）监测骨质疏松症治疗; 5）骨质疏松症病例发现; 6）质量保证和控制。存在许多QUS设备，这些设备在它们测量的参数和支持它们使用的经验证据的强度方面非常不同。一般来说，脚跟QUS似乎是最测试和最有效的。总体而言，一些（但不是全部）足跟QUS器械可有效评估某些（但不是全部）人群的骨折风险，对于55岁以上的白人女性证据最强。否则，某些器械的证据是公平的，可以准确诊断骨质疏松症的可能性，并且在启动或监测骨质疏松症治疗时，QUS的使用通常是公平到差。本文提出了一个合理的方案，用于病例发现的目的，它依赖于临床风险因素（CRF）和足跟QUS的综合评估。最后，对质量保证和控制提出了几点建议。
For the detection and management of osteoporosis and osteoporesis-related fractures, quantitative ultrasound (QUS) is emerging as a relatively low-cost and readily accessible alternative to dual-energy X-ray absorptiometry (DXA) measurement of bone mineral density (BMD) in certain circumstances. The following is a brief, but thorough review of the existing literature with respect to the use of QUS in 6 settings: 1) assessing fragility fracture risk; 2) diagnosing osteoporosis; 3) initiating osteoporosis treatment; 4) monitoring osteoporosis treatment; 5) osteoporosis case finding; and 6) quality assurance and control. Many QUS devices exist that are quite different with respect to the parameters they measure and the strength of empirical evidence supporting their use. In general, heel QUS appears to be most tested and most effective. Overall, some, but not all, heel QUS devices are effective assessing fracture risk in some, but not all, populations, the evidence being strongest for Caucasian females over 55 years old. Otherwise, the evidence is fair with respect to certain devices allowing for the accurate diagnosis of likelihood of osteoporosis, and generally fair to poor in terms of QUS use when initiating or monitoring osteoporosis treatment. A reasonable protocol is proposed herein for case-finding purposes, which relies on a combined assessment of clinical risk factors (CRF) and heel QUS. Finally, several recommendations are made for quality assurance and control.