Ubunini bw'amagufwa ya spine na hip byapimwe na DXA
Ukuri kwa DXA mu gupima ibice bitandukanye bigize umubiri wumuntu biratandukanye [4-7].Ukuri kwa DXA mugupima umugongo ni 0.5% ~ 2%, ariko mubisanzwe> 1%.Ikibuno cyukuri ni 1% ~ 5%, hamwe nijosi ryumugore na rotor nini (1% ~ 2%) iruta inyabutatu ya Ward (2.5% ~ 5%) (4. 6. 8).Nubwo ibice byinshi byamagufwa ya kanseri muri mpandeshatu ya Ward hamwe no kumva neza impinduka muri BMD [9], kutamenya neza kwayo bitewe n'ahantu hakeye hateganijwe hamwe namakosa yatanzwe hamwe nibisubirwamo bigabanya imikoreshereze yubuvuzi.Kugirango ugabanye ingaruka zumwanya wo gusikana neza mugihe ukora ibipimo bya DXA, ikibuno n'amavi byahinduwe ku nkunga yo kwemerera urutirigongo kuba ukuri kuri platifomu yo kugabanya nyababyeyi mu gihe cyo kumenya BMD mu mwanya wa anteroposteric lumbar (posteroposteric) PA).Mugihe cyo gusikana ikibuno, ikibero cyashimuswe gato kandi kivugwa, kandi hifashishijwe igikoresho cyo gukosora posita, ijosi ryigitsina gore ryashyizwe kumurongo ugereranije nimeza yo kubisikana kugirango wirinde kwiyongera kwa BMD kubera kugabanya ijosi ryumugore (kugabanya amajwi kuri kimwe amagufwa yuzuye).Mu kugena ikibuno BMD na DXA, imyanya itandukanye yamaguru irashobora gutera amakosa akomeye, kuva kuri 0.9% kugeza kuri 4.5% kumajosi yumugore, 1.0% kugeza 6.7% kuri mpandeshatu ya Ward, na 0.4% kugeza 3.1% kubantu benshi [6].Kubwibyo, iyo DXA isikana ikibuno, igihagararo gikwiye kizagabanya cyane ikosa, arirwo rufunguzo rwo kwemeza neza neza Inguni.
Niba ibisubizo bya hip BMD byapimwe na DXA bidahuye nibigaragara kwa clinique, bigomba gukorwa
Umwanditsi agomba kugenzura niba umwanya wo gusikana ariwo;Kurundi ruhande, abaganga bagomba gusuzuma ingaruka zumwanya wo gusikana kuri BMD.Usibye ingaruka zumwanya muburyo bwo gupima DXA, izindi mpamvu zishobora no kugira ingaruka kubipimo.Guhuza umugongo byagenwe na DXA.
Uruti rw'umugongo BMD rusobanurwa nk'ubucucike bw'umubiri wose w'urugingo, harimo umubiri wa vertebral na arch (igufwa rya cortical to bone cancellous bone ratio 50:50), calcisation ya aortic, degenerative osteoarthrosis, osteopanthogenic spinous process, callus, hamwe no kuvunika kwa compression, ibyo byose bikaba Kugira uruhare mu kongera amagufwa yubunini.Nyamara, impinduka zangirika nka hyperosteoplasia zikunze kugaragara cyane ku bageze mu za bukuru barengeje imyaka 70, aho usanga abantu barenga 60%, ibyo bikaba bigabanya imikorere n’ubukangurambaga bwa DXA umugongo wa orthotopique mu bageze mu zabukuru.Indwara ya osteoporose ni myinshi kandi ikomeye kubantu bageze mu za bukuru ndetse n'abasaza
Nindwara isanzwe yubusaza ibangamira ubuzima bwabantu bageze mu zabukuru ndetse nabasaza.Mu rwego rwo gukuraho ingaruka ziterwa n’ibintu byavuzwe haruguru, iterambere ry’ikoranabuhanga rya DXA lumbar latal scanning (1121, scaneri ya DXA yo hambere kubindi bisuzumwa byo mu gihimba, indwara ikunda kugumana umwanya wo gusikana, aribyo
Byagize ingaruka ku kuri, byari 2.8% kugeza 5.9%!
Mugihe kimwe n'indwara zimwe
Abantu, cyane cyane abafite osteoporose ikabije, bafite ikibazo cyo guhinduka.
Mu myaka yashize, scaneri ya DXA ifata urumuri rumeze nk'umufana ruzunguruka “C” rusikana amaboko, rwemerera indwara
Uruti rw'umugongo BMD rwapimwe anteroposterically mu mwanya mwiza kandi scaneri ya C-arm yazungurutswe 90 °
Umurwayi arashobora gupimwa na DXA mumwanya wanyuma winkingi yicyubahiro atimutse
Ibipimo byo gupima impande zombi byari 1,6% mu masomo asanzwe na 2% ku barwayi barwaye osteoporose.Igipimo cyiza cya DXA cyiza kigomba gusesengura BMD ya vertebrae 4 (L1-L).Ariko, L1 na L4 birashobora gupfukirana imbavu kandi biragaragara ko L4 yuzuyeho igufwa rya pelvic.Ku barwayi bamwe, hashobora gusesengurwa L3 BMD gusa.ROIS (akarere gashimishije) irashobora kandi kuba hagati yumubiri wurugingo rukungahaye kumagufwa ya kanseri (igufwa ryamagufwa / igufwa ryamagufwa ya 10: 90), bigatuma ibipimo bya DXA byumva neza impinduka muri BMD kuruhande kuruta uko bigaragara imbere .DXA ikurikira ikoreshwa mubintu bizima hamwe na osteoporose yinkingi (kuvunika vertebral compression)
Ivangura riri hagati yo gutakaza amagufwa yatewe na corticosteroide ni ryiza kuruta irya PA-DXA, ritezimbere ubushobozi bwo gutandukanya kuvunika kwurugingo n’utavunika [15].Nubwo DXA yateye imbere cyane mugupima umugongo BMD.Nyamara, kuri scoliose, guhubuka gukabije no gutandukanya umugongo udasanzwe [4,61], imikorere yo gusikana DXA iragoye, bigira ingaruka kumyizerere ya DXA no kugabanya ikoreshwa rya clinique ya DXA.Iyindi nyigisho irakenewe kugirango ugereranye "volumetric" BMD (mg / cm3) ibarwa hamwe n'ibipimo bya DXA byimbere hamwe kuruhande hamwe nuburyo bwa QCT.
Kumenya amaboko BMD hamwe nibigize umubiri na DXA
DXA ikoreshwa cyane mukumenya amaboko BM [17].Ibipimo bya BMD byakorewe kuri radiyo ya kure (yiganjemo kanseri), hagati na hagati, na kimwe cya gatatu cya radiyo (yiganjemo cortical) hamwe n'umurwayi yicaye ku ntebe yegeranye na scanne hamwe n'ukuboko gushyizwe kuri platifomu kandi ikiganza gishyizwe kuri platifomu hamwe no kuzenguruka imbere.Umubiri wose amagufwa densitometrie nayo arashobora gukorwa.Ibi bitanga igereranya ryimibiri yose BMD na BMD yaho.Gusesengura no gucukumbura isano iri hagati ya BMD itunganijwe na BMD yaho, ukanamenya urubuga rworoshye rwa densitometrie yamagufwa, kugirango utange amahitamo meza kubavuzi.Ukuri kwumubiri wose BMD gupima ni 3% kugeza 8%.19] Ukuri kwamaboko BMD ni 0.8% -13%.Kuberako ubunyangamugayo bwa DXA umubiri wose BMD buri munsi ugereranije nibindi bice, igufwa rinanutse
Kurekura mubisanzwe ntabwo ari urubuga rwa scan rwo gusuzuma.Ibisubizo byo gusikana umubiri wose byasesenguwe na sisitemu yamakuru ya software yingingo zikwiye zabantu (imitsi itagabanije hamwe n’ibinure), kandi ibisubizo byo kugena umubiri byabonetse na DXA.Isano riri hagati y ibisubizo byo kugena umubiri hamwe nubundi buryo bwo gupima uburemere butaziguye byari byiza.Numwanya wingenzi ushobora gukomeza kwigwa.
Igihe cyo kohereza: Kanama-10-2022