DXA an auna yawan ma'adinan kashin baya da hip
Daidaiton DXA wajen auna sassa daban-daban na jikin mutum ya bambanta [4-7].Daidaiton DXA wajen auna kashin baya shine 0.5% ~ 2%, amma yawanci> 1%.Daidaiton hip shine 1% ~ 5%, tare da wuyan mata da babban rotor (1% ~ 2%) ya fi alwatika na Ward (2.5% ~ 5%) (4. 6. 8).Duk da babban abun ciki na soke kashi a cikin triangle na Ward da kuma girman hankalinsa ga canje-canje a cikin BMD [9], rashin daidaituwarsa saboda ƙaramin yanki na tsinkaya da samfuri da kurakuran maimaitawa yana iyakance aikace-aikacen asibiti.Don rage girman tasiri na matsayi na dubawa akan daidaito lokacin da ake yin ma'auni na DXA, hips da gwiwoyi sun kasance masu sassaucin ra'ayi a kan goyon baya don ba da damar kashin baya ya zama gaskiya a kan dandamali don rage lumbar lordosis a lokacin ƙaddarar BMD a cikin matsayi na anteroposteric lumbar (posteroposteric). PA).A lokacin duban hips, cinyar ta ɗan ɗan yi awon gaba da ita, kuma tare da taimakon na'urar gyarawa, wuyan femoral ɗin ya kasance daidai da tebur na dubawa don guje wa ƙara BMD saboda gajarta wuyan femoral (raguwar ƙarar don iri ɗaya). abun ciki na ma'adinan kashi).A cikin ƙaddarar BMD hip ta DXA, matsayi daban-daban na ƙafa zai iya haifar da kurakurai masu mahimmanci, daga 0.9% zuwa 4.5% don wuyan mata, 1.0% zuwa 6.7% don triangle na Ward, da 0.4% zuwa 3.1% don mafi girma trochanter [6].Don haka, lokacin da DXA ta duba kwatangwalo, daidaitaccen matsayi zai rage kuskure sosai, wanda shine mabuɗin don tabbatar da daidaitaccen kusurwa.
Idan sakamakon BMD na hip da aka auna ta DXA bai dace da bayyanar asibiti ba, ya kamata a yi ɗaya
Ya kamata marubucin ya duba ko wurin dubawa daidai ne;A gefe guda, likitocin ya kamata suyi la'akari da tasirin matsayi na dubawa akan BMD.Baya ga tasirin matsayi akan daidaiton ma'aunin DXA, wasu dalilai kuma na iya shafar sakamakon ma'aunin.DXA ne ya ƙaddara daidaitawar kashin baya.
Spinal BMD an ayyana shi azaman yawa na gabaɗayan yanki na vertebral, ciki har da jikin vertebral da baka (kashi na cortical don soke kashi kashi 50:50), ƙididdiga na aortic, degenerative osteoarthrosis, osteopanthogenic spinous tsari, callus, da matsawa karaya, wanda duk. taimakawa wajen kara yawan ma'adinan kashi.Duk da haka, sauye-sauye na lalacewa irin su hyperosteoplasia suna da yawa a cikin tsofaffi fiye da shekaru 70, tare da yawancin fiye da 60%, wanda ya iyakance aiki da hankali na DXA spine orthotopic ma'auni a cikin tsofaffi.Abubuwan da ke faruwa na osteoporosis yana da girma kuma mai tsanani a cikin masu matsakaici da tsofaffi
Wata cuta ce da ta zama ruwan dare gama gari na tsufa da ke barazana ga lafiyar masu matsakaita da tsofaffi.Don kawar da tasirin abubuwan da ke sama, ci gaba da fasaha na fasaha na fasaha na DXA na lumbar (1121, farkon DXA na'urar daukar hotan takardu don sauran na'urorin lumbar, cutar tana da wuyar kula da matsayi na dubawa, wanda yake shi ne.
Ya shafi daidaito, wanda shine 2.8% zuwa 5.9%!
A lokaci guda ga wasu cututtuka
Mutane, musamman masu fama da ciwon kasusuwa, suna da wahalar juyowa.
A cikin 'yan shekarun nan, na'urar daukar hotan takardu ta DXA tana ɗaukar katako mai siffar fanti mai jujjuyawa "C" na'urar duba hannu, yana ba da damar cuta.
An auna BMD na kashin baya a matsayin baya kuma an juya na'urar daukar hoto ta C-arm 90°
Ana iya auna majiyyaci ta DXA a cikin matsayi na gefe na ginshiƙin suna ba tare da motsi ba
Daidaiton ma'auni na gefe shine 1.6% a cikin batutuwa na al'ada da 2% a cikin marasa lafiya tare da osteoporosis.Kyakkyawan ma'aunin DXA na gefe ya kamata yayi nazarin BMD na 4 lumbar vertebrae (L1-L).Koyaya, L1 da L4 na iya rufe haƙarƙari kuma L4 a fili yana mamaye ƙashin ƙashin ƙugu.Ga wasu marasa lafiya, L3 BMD kawai za a iya bincikar su.Hakanan ROIS (yankin sha'awa) na iya kasancewa a tsakiyar jikin kashin baya mai wadatar kasusuwan soket (kashi na cortical / soke kashi na 10:90), yana sa ma'aunin DXA ya fi kula da canje-canje a BMD a gefe fiye da hangen nesa na gaba. .Ana amfani da DXA na gefe a cikin batutuwa masu lafiya tare da osteoporosis na columnar (kayawar vertebral matsawa)
Bambance-bambance tsakanin asarar kasusuwa da corticosteroids ke haifarwa ya fi na PA-DXA, wanda ke inganta ikon rarrabe ɓarkewar ɓarna daga ɓarna [15].Kodayake DXA ta sami babban ci gaba wajen auna BMD na kashin baya.Koyaya, don scoliosis, humpback mai tsanani da ɓarna na kashin baya [4,61], aikin sikanin DXA yana da wahala, yana shafar daidaiton ƙaddarar DXA da iyakance aikace-aikacen asibiti na DXA.Ana buƙatar ƙarin nazarin don kwatanta "volumetric" BMD (mg/cm3) da aka ƙididdige su ta hanyar haɗin gaba da ma'aunin DXA na gaba tare da hanyar QCT.
Ƙaddamar da BMD na gaba da haɗin jiki ta DXA
Ana ƙara amfani da DXA don ƙayyade BM[17].An yi ma'aunin BMD a cikin radius mai nisa (wanda aka soke), na tsakiya da na tsakiya, da kuma na uku na radius (predominance cortical) tare da majiyyaci zaune a kan kujera kusa da dandalin dubawa tare da goshin da aka sanya a kan dandamali kuma an gyara hannun. akan dandamali tare da juyawa na baya.Hakanan ana iya yin densitometry na kashi gaba ɗaya.Wannan yana ba da kwatancen tsari na BMD gabaɗayan jiki da BMD na gida.Don bincika da bincika alaƙar da ke tsakanin tsarin BMD da BMD na gida, da kuma gano wuri mai mahimmanci na densitometry na kashi, don samar da mafi kyawun zaɓi ga likitocin.Daidaiton ma'aunin BMD gaba ɗaya shine 3% zuwa 8%.19] Daidaiton hannun gaban BMD shine 0.8% -13%.Domin daidaiton BMD gabaɗayan jiki na DXA bai kai na sauran sassa ba, ƙashi siriri ne
Sako da gabaɗaya ba shine wurin da aka fi so don bincikar ganewar asali ba.An bincikar sakamakon binciken gaba ɗaya ta hanyar tsarin bayanan software na kyallen jikin ɗan adam da suka dace (ƙwaƙwalwar tsoka da kitse), kuma an sami sakamakon ƙaddarar ƙirar jiki ta DXA.Daidaita tsakanin sakamakon ƙaddarar ƙirar jiki da sauran hanyoyin auna nauyi kai tsaye yana da kyau.Fage ne mai mahimmanci wanda za a iya kara nazari.
Lokacin aikawa: Agusta-10-2022