股骨定位对双能量 X 射线吸收测量法(DXA)测量结果以及统计形状和外观建模(SSAM)骨折风险评估的影响。

IF 1.7 4区 医学 Q3 ENGINEERING, BIOMEDICAL
Ali Ammar, Fatemeh Jazinizadeh, Jonathan D Adachi, Cheryl E Quenneville
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引用次数: 0

摘要

使用双能 X 射线吸收测定法(DXA)诊断骨质疏松症依赖于精确的髋部扫描,而患者体位的改变可能会导致测量结果的变化,长期重复扫描就会出现这种情况。本文的目的是测试姿势改变如何影响股骨定位的诊断指标(即标准临床指标和较新的图像处理工具)。我们制作了一个装置来支撑尸体股骨,并以屈曲和内/外旋 3° 的增量调整其方向。在六种屈曲姿势(0°(中立)至 15°屈曲)和十一种旋转姿势(15°外旋至 15°内旋)下对七个孤立的股骨进行扫描,同时收集每次扫描的标准临床 DXA 测量数据。骨折风险工具适用于每次扫描,以计算骨折风险。对基于 DXA 的测量结果和骨折风险预测输出结果分别进行了两次单因素重复测量方差分析(α = 0.05)。当角度大于 12°时,屈曲对 T 评分、骨矿物质密度 (BMD) 和骨矿物质含量 (BMC) 有明显影响,但对面积没有影响。内旋和外旋对任何临床指标都没有显著影响。骨折风险(由图像处理工具评估)不受两种旋转模式的影响。总体而言,这表明如果偏差小于 12 度,临床医生可以调整患者的姿势以适应不适,而在屈曲时应格外小心。此外,该工具对体位调整的敏感度相对较低,因此可能是跟踪重复患者扫描风险的不错选择。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The effect of femur positioning on dual-energy X-ray absorptiometry (DXA) measures and statistical shape and appearance modeling (SSAM) fracture risk assessments.

The diagnosis of osteoporosis using Dual-energy X-ray Absorptiometry (DXA) relies on accurate hip scans, whereby variability in measurements may be introduced by altered patient positioning, as could occur with repeated scans over time. The goal herein was to test how altered postures affect diagnostic metrics (i.e., standard clinical metrics and a newer image processing tool) for femur positioning. A device was built to support cadaveric femurs and adjust their orientation in 3° increments in flexion and internal/external rotation. Seven isolated femurs were scanned in six flexion postures (0° (neutral) to 15° of flexion) and eleven rotational postures (15° external to 15° internal rotation) while collecting standard clinical DXA-based measures for each scan. The fracture risk tool was applied to each scan to calculate fracture risk. Two separate one-way repeated measures ANOVAs (α = 0.05) were performed on the DXA-based measures and fracture risk prediction output. Flexion had a significant effect on T-score, Bone Mineral Density (BMD), and Bone Mineral Content (BMC), but not area, at angles greater than 12°. Internal and external rotation did not have a significant effect on any clinical metric. Fracture risk (as assessed by the image processing tool) was not affected by either rotation mode. Overall, this suggests clinicians can adjust patient posture to accommodate discomfort if deviations are less than 12 degrees, and the greatest care should be taken in flexion. Furthermore, the tool is relatively insensitive to postural adjustments, and as such may be a good option for tracking risk over repeated patient scans.

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来源期刊
CiteScore
3.60
自引率
5.60%
发文量
122
审稿时长
6 months
期刊介绍: The Journal of Engineering in Medicine is an interdisciplinary journal encompassing all aspects of engineering in medicine. The Journal is a vital tool for maintaining an understanding of the newest techniques and research in medical engineering.
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