Quantitative heel ultrasound as a predictor for osteoporosis

作     者：Naganathan, V March, L Hunter, D Pocock, NA Markovey, J Sambrook, PN 

作者机构：Royal N Shore Hosp Dept Rheumatol Sydney NSW Australia St Vincents Hosp Dept Nucl Med Sydney NSW 2010 Australia 

出 版 物：《MEDICAL JOURNAL OF AUSTRALIA》 (Med. J. Aust.)

年 卷 期：1999年第171卷第6期

页      面：297-300页

核心收录：

学科分类：1002[医学-临床医学] 10[医学] 

主　　题：骨密度 骨疾病 代谢性/放射摄影术 骨疾病 代谢性/超声检查 跟骨/超声检查 似然函数 骨质疏松 绝经后/放射摄影术 骨质疏松 绝经后/超声检查 敏感性与特异性 老年人 老年人 80以上 女(雌)性 人类 中年人 

摘      要：Objective: To determine the diagnostic value of quantitative ultrasound (QUS) to predict bone mineral density (BMD) categories as defined by dual-energy x-ray absorptiometry. Design: Cross-sectional survey. Setting: Rheumatology department of a tertiary care hospital (Royal North Shore Hospital, Sydney, NSW), 1997-1998. Subjects: 326 healthy women aged 45-80 years who had volunteered for a twin study. Our study included both members of non-identical twin pairs but only one randomly selected member of identical twin pairs. Main outcome measures: BMD categories as defined by dual-energy x-ray absorptiometry of lumbar spine and left hip, and QUS of calcaneus;sensitivity, specificity and likelihood ratios (LRs) of QUS parameters to diagnose osteoporosis as defined by BMD. Results: The sensitivity of QUS to diagnose BMD osteoporosis varied between 9% and 47%, depending on the QUS parameter. The specificity of QUS was high (88%-100%). If all QUS parameters were normal, osteoporosis was unlikely (LR, 0-0.2). One QUS parameter, broadband ultrasound attenuation (BUA), was highly predictive of osteoporosis by BMD when in the osteoporotic range (LR, infinity), but had low sensitivity (9%). QUS results in the osteoporotic range for other parameters and all QUS results in the osteopenic range were less predictive (LR, 1.0-5.2) of osteoporotic BMD. Conclusion: These results suggest that, for most of those tested for osteoporosis by QUS in the community, uncertainty remains about expected BMD.