Postmenopozal kadınlarda dijital x-ışını radyogrammetri bulguları ile kemik mineral yoğunluğu ilişkisi

Bu çalışmada, dijital radyografilerde elde edilen radyogrammetrik ölçümler ile dual enerji X- ışını absorbsiyometri (DEXA) kullanarak saptanan kemik mineral yoğunluğu (KMY) arasındaki ilişki araştırıldı. Çalışmaya 57 postmenopozal kadın alındı. Nondominant el ikinci metakarpal kemiğin" dijital ortamdaki radyografik görüntülerinde, kemiğin uzun aksının tam orta noktasında dış çap (DÇ) ve iç çap (İÇ) ölçümleri yapıldı. Bu iki değer kullanılarak basit geometrik işlemlerle kombine kortikal kalınlık (KKK), kortikal alan (KA), medüller alan (MA), metakarpal indeks (Mİ) ve kortikal oran (KO) değerleri hesaplandı. DEXA ölçümleri sonucu 28 olgu osteoporoz grubunu, saptanmayan 29 olgu kontrol grubunu oluşturdu. İÇ ve MA osteoporozlu olgularda anlamlı olarak yüksek (p

Correlation between digital x-ray radiogrammetry findings and bone mineral density in postmenopausal women

The relation between bone mineral density (BMD) determined by dual energy X ray absorptiometry (DEXA) and radiogrammetric measurements on digital radiographies was investigated in this study. Fifty-seven postmenopausal women who had applied for DEXA measurement were included in the study. External diameter (ED) and internal diameter (ID) measurements were performed on the midpoints of the longitudinal axis of the nondominant second metacarpal bone on digital radiographic images. By using these two measurement values, the combined cortical thickness (COT), cortical area (CA), medullary area (MA), metacarpal index (Ml) and cortical ratio (CR) values were determined by simple geometrical calculations. The osteoporosis group had 28 women and the control group 29 women after DEXA evaluations. ID and MA were found to be significantly higher (p<0.001); and CCT, CR and Ml significantly lower (p<0.001) in women with osteoporosis. BMD of lumbar spine (vertebrae L2-L4) positively correlated with CCT (p<0.05). Positive correlations were found between BMD of femur neck and CCT (p<0.001), Ml, CR (p<0.05). BMD of femur Ward's triangle correlated with CCT, Ml and CR positively while it correlated negatively with ID and MA (p<0.001). Similarly BMD of femur trochanter showed positive correlations with CCR, CA, Ml, CR (p<0.001), and negative correlations with ID and MA (p<0.05). No significant thres-hold value could be provided in the ROC curves in order to discriminate patients with osteoporosis from normal. The concordant relations found between bone geometry measurements and DEXA seemed to be encouraging to prove probably the value of digital radiogrammetry for the discrimination of osteoporotic patients from normal, in studies with larger patient population

Kaynakça

1. Bouxsein ML, Palermo L, Yeung C, et al A Digital X-ray radiogrammetry predicts hip, wrist and vertebral fracture risk in elderly women: a prospective analysis from the study of osteoporotic fractures. Osteoporos Int. 2002;13(5):358-65. 2. Rosholm A, Hyldstrup L, Backsgaard L, et al. Estimation of bone mineral density by digital X-ray radiogrammetry: theoretical background and clinical testing. Osteoporos Int. 2001;12(11):961-9. 3. Ward KA, Cotton J, Adams JE. A technical and clinical evaluation of digital X-ray radiogrammetry Osteoporos Int. 2003;14(5):389-95. 4. Zanberlan N, Padetti G, Paganini C, et al. Evaluation of cortical thickness and bone density by roentgen microdensitometry in growingmales and females. Eur J Pediatr 1996;155:377-382. 5. Aguado F, Revilla M, Villa LF, et al. Cortical bone resorption in osteoporosis. Calcif Tissue Int. 1997;60(4):323-6. 6. Crespo R, Revilla M, Usabiago J, et al. Metacarpal radiogrammetry by computed radiography in postmenopausal women with Colles fracture and vertebral crush fracture syndrome. Calcif Tissue Int. 1998;62(5):470-3. 7. Jorgansen JT, Andersen PB, Rosholm A, et al. Digital X-ray radiogrammetry: a new appendiculer bone densitometric method with high presicion. Clin Physiol 2000;20:330-5. 8. Dey A, mcCloskey E, Taube T, et al. Metacarpal morphgometry using a semi-automated technique in the assesment of osteoporosis and vertebral fracture risk. Osteoprosis Int 2000; 11:953-8. 9. Ohisihi T, Kushida K, Takahashi M, et al. Urinary bone resorption markers in patients with metabolic bone disorders. Bone 1994;15:15-20. 10. Seeman E. Reduced bone formation and increased bone resorption: rational targets for treatment of osteoporosis. Osteopororsis Int. 2003;14(suppl 3):2-8. 11. Ahlborg HG, Johnell O, Turner CH, et al. Bone loss and bone size after menopause. N Engl J Med. 2003 24;(4):327-34. 12. Celiktas M, Kozanoglu E, Aikimbaev KS, et al. Osteopenia and osteoporosis in postmenopausal women. Assessment by radiogrammetric measurement. Acta Radiol. 2002;43(6):609-14. 13. Nanyan P, Pothuaud L, Benhamou L, et al. Semi-automated evaluation of the cortico-medullar index on radius radiographs: a study prepubertal girls. Eur J Radeiol 2003 17(1):47-53. 14. Hyldstrup L, Nielsen SP. Metacarpal index by digital X-ray radiogrammetry: normative reference values and comparison with dual X-ray absorbtiometry. J Clin Densitom 2001 4:299-306.

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