Mass Examination for Osteofluorosis and Osteoporosis,Using Dual-Energy X-ray Absorptiometry

由于工业化和社会老龄化，氟骨症（骨硬化）和骨质疏松症的发病率正在迅速上升，为了预防这些疾病，我们建立了一种使用骨密度计检测两种骨病的大规模检查方法。基础研究使用Norland XR-26（美国）双能x射线吸收仪（DEXA）进行；从灵敏度、准确性、测量时间和非侵入性的角度来看，该系统被认为是最适合测量骨矿物质含量的。测定值的波动系数在体外小于1%，在体内小于2%，精度较好。在测量精度方面，定量计算机断层扫描（QCT）的标准幻影测量值与标称值之间存在线性关系。此外，用热释光剂量计进行的测量基本上没有散射辐射。在确定最适合肿块检查的区域时，对身体的各个区域进行了评估，发现腰椎前后方向（L_2-L_4）在所需的时间、准确性和测量的便性方面是最适合检查的。正常成人该区域骨密度（BMD）常高于1.000g/cm^2；尽管在男性中骨密度基本没有随年龄变化，但在40多岁和50多岁的女性中，骨密度有迅速下降的趋势。关于骨氟症，对生活在饮用水中氟化物含量高的地区的居民进行了骨密度测量，这些地区分散在北九州霍曼河流域。测量结果表明，饮用含氟化物含量高的水与骨密度增加之间存在一定的相关性。诊断系统安装在一辆检查车上，我们在现场进行了大量检查。腰椎前后方向测量每人大约需要10分钟；因此，每天可以检查40人。在对大约300名骨质疏松症患者的测量中，发现16.1%的成年女性骨密度值比我们建立的设定值低1SD。此外，在调查期间对人们进行的行为访谈显示，在骨密度低的人群中发现了骨质疏松症的传统风险因素，如缺乏钙摄入或缺乏运动等趋势。在本研究中，建立了一种使用DEXA和车载骨密度仪对氟骨症和骨质疏松症进行肿块检查的方法，并发现该方法可有效预防骨病。少

In response to efforts to prevent osteofluorosis (osteosclerosis) and osteoporosis, the incidence of which is rapidly increasing due to industrialization and aging of the society, we established a mass examination method using a bone densitometer to test for two types of osteopathies. Basic studies were conducted using a Norland XR-26 (USA) system for dual-energy X-ray absorptiometry (DEXA); this system is considered to be the most suitable for measurement of bone mineral content from the standpoint of sensitivity, accuracy, measurement time, and noninvasive properties. The fluctuation coefficients of measurements were less than 1% in vitro and less than 2% in vivo with good precision. Regarding the accuracy of measurements, a linear relationship between measured values of standard phantoms of quantitative computed tomography (QCT) and nominal values was found. Furthermore, there was essentially no scattering radiation in the measurements performed with a thermoluminescence dosimeter. … More Various regions of the body were evaluated in the determination of the most appropriate region for mass examination, and the anterior-posterior direction of the lumbar spine (L_2-L_4) was found to be optimum for examination in terms of required time, accuracy, and ease of measurement. The bone mineral density (BMD) of the region in normal adults is often higher than 1.000g/cm^2; although essentially no change in BMD with age was found in males, a tendency toward rapid decrease was observed in females in their 40s and 50s. With respect to osteofluorosis, BMD was measured in residents living in areas where the fluoride content in drinking water is high--areas scattered throughout the Homan river Basin in North Kyushu. The results of measurements indicated a certain correlation between consumption of water containing a high level of fluoride and an increase in BMD. The diagnostic system was mounted on an examination vehicle, and we conducted mass examinations in the field. Measurements made in the anterior- posterior direction on the lumbar spine required approximately 10min.per person; thus examination of 40 persons per day was possible. From the measurements of approximately 300 persons for osteoporosis the value of BMD was found to be 1SD lower than a set value established by us in 16.1% of female adults. Also, behavioral interviews carried out on people during the investigation revealed that conventionally reported risk factors for osteoporosis, trends such as lack of calcium intake or lack of exercise, were found among low-BMD individuals. In the present study, a method using DEXA and a vehicle-mounted bone densitometer for mass examination of osteofluorosis and osteoporosis has been established and found to be effective in the prevention of osteopathies. Less