小腿围测量判断劣势腿在骨密度测量中的临床意义  

The Clinical Value of Judging Nondominant Leg by Calf Circumference in the Bone Mineral Densitometry

作　　者：龙淼淼[1] 刘丽华[1] 张晨[1] 冯杰[1] 沈文[1] 祁吉[1] 

机构地区：[1]天津市第一中心医院,300192

出　　处：《临床放射学杂志》2011年第9期1337-1340,共4页Journal of Clinical Radiology

摘　　要：目的探索小腿围测量判断劣势腿在骨密度测量中的应用价值。资料与方法前瞻性连续选择46例行腰椎和左髋部双能X线骨密度检查的患者(排除髋部、腿部疾患,明显疼痛症状和肢体不利者等),经患者知情同意后,同时行右髋部检查,进行双髋部骨密度、T值的配对统计学检验,小腿围之差与相应部位骨密度、T值差值的相关性分析,以三个部位的最低T值为金标准,比较腰椎、左髋部、右髋部、优势侧髋部、劣势侧髋部及腰椎和各髋部组合T值的骨质疏松、骨量减低、骨量正常的诊断性指标,进一步分析双髋部T值不在同一诊断类别的患者。结果双髋部骨密度、T值差异无显著性,双侧小腿围之差与双侧髋部相应部位骨密度、T值之差无相关性,组合腰椎与劣势侧髋部T值的诊断敏感性、特异性、阳性预测值、阴性预测值、准确率最高,均为100%。结论根据小腿围判断劣势腿组合腰椎是最佳骨密度组合测量方法。Objective To investigate the clinical value of leg functional laterality judgment using calf circumference in the bone mineral densitometry.Materials and Methods 46 patients ordered for lumbar spine and left hip dual-energy X-ray absorptiometry（DXA） were prospectively and continuously selected to perform the extra right hip examination after the exclusion of patients with hip or leg disease,pain,hemiplegia and so on.Informed consent was obtained before each procedure.Paired t-test was performed for regional bone mineral density and T-score between bilateral hips.Correlation analysis was performed between the differences of calf circumference and that of regional bone mineral density and T-score of bilateral hips.The diagnostic efficacy of lumbar spine,right hip,left hip,the dominant hip,the weak hip and the combination of lumbar spine with different hips were evaluated,the lowest T-score of lumber spine and bilateral hips was taken as gold standard.The discordance of bilateral hips T-score was further investigated.Results There was no statistically significant difference between regional bone mineral density and T-score between bilateral hips.No statistically significant correlation was found between the difference of calf circumference and that of regional BMD,or T-score of bilateral hips.The combination of lumber spine and weak hip was the best,which sensitivity,specificity,positive and negative predictive value,accuracy were all 100%.Conclusion The combination of weak hip judged by calf circumference measurement and lumbar spine is the best way to perform bone mineral densitometry.

关 键 词：骨密度 双能X线吸收法 劣势侧 髋 小腿围 

分 类 号：R580[医药卫生—内分泌]