Vertebral ve vertebra dışı fraktürü olan yaşlı olgularda dual–enerji X-ışını absorbsiyometri ve kantitatif bilgisayarlı tomografi karşılaştırması: Preliminar sonuçlar

Öz

Amaç: Günümüzde Dual-enerji X-ışını absorbsiyometrisi (DXA) ve kantitatif bilgisayarlı tomografi (KBT) kemik kütle ve yapısını değerlendirmek, kırık riskini belirlemek için kullanılan yöntemlerdir. Bu çalışmada vertebral ve vertebral bölge dışında kırığı olan yaşlı hastalarda, DXA ve KBT ile ölçülen spinal ve femoral bölge dansitometri sonuçlarını karşılaştırarak, osteoporoz ve kırık riskini belirlemede en etkin yöntemi araştırmayı amaçladık. Yöntemler: Bu retrospektif kohort çalışmasında 65- 84 yaş aralığında 45 yaşlı hasta analiz edildi. Grup 1’e atravmatik vertebral kırığı olan 11 hasta, Grup 2’ ye spinal bölgenin dışında kırığı olan 11 hasta, Grup 3’e ise kırığı olmayan 23 hasta dahil edildi. Spinal (lumbar 1-4) ve femoral (boyun) bölgelerden ölçülen, DXA ve KBT ile yapılan kemik mineral yoğunluğu (BMD) ölçümleri ve T skorları değerlendirildi. Bulgular: Gruplar arası değerlendirmede, DXA ve KBT ile ölçülen, lumbar ve femoral boyun BMD değerlerinde ve T skorlarında üç grup arasında istatistiksel olarak anlamlı bir farklılık bulunmadı (tümü P>0,05). Grup 1’de KBT ile ölçülen lumbar BMD değeri, lumbar ve femoral boyun T skor değerleri, DXA ölçümlerinden istatistiksel olarak anlamlı düşük bulundu (sırasıyla, P<0,001, P=0,004 ve P=0,037). Grup 2’de KBT ile ölçülen lumbar bölge BMD ve lumbar bölge T skor değerleri, DXA ölçümlerinden istatistiksel olarak anlamlı derecede düşük bulundu (P<0,001 ve P<0,001). Grup 3’de KBT lumbar bölge T skoru, lumbar ve femoral boyun BMD değerleri, DXA ölçümlerinden istatistiksel olarak anlamlı derecede düşük dulundu (sırasıyla, P<0,001, P<0,001 ve P=0,004). Sonuç: KBT, ileri yaş olgularda kırık ve artroz gibi DXA yönteminin yanlış pozitiflik verebileceği durumlarda kullanılabilecek etkin bir kemik mineral yoğunluğu ölçüm metodudur.

Anahtar Kelimeler

• Yaşlı
• Osteoporoz
• Spinal kırık
• Kemik yoğunluğu
• DXA
• KBT

Comparison of quantitative computed tomography and dual-energy X-ray absorptiometry in elderly patients with vertebral and nonvertebral fractures: Preliminary results

Abstract

Aim: Dual-energy X-ray absorptiometry (DXA) and quantitative computed tomography (QCT) are methods used today to evaluate bone mass and structure and determine the risk of fractures. In this study, spinal and femoral bone density results measured by DXA and QCT in elderly patients with vertebral and non-vertebral fractures were compared to identify the most effective method in determining the risk of osteoporosis and fractures. Methods: In this retrospective cohort study, 45 elderly patients aged 65–84 years were analyzed. Group 1 included 11 patients with atraumatic vertebral fractures, Group 2 included 11 patients with non-vertebral fractures and Group 3 included 23 patients without fractures. T-scores and bone mineral density (BMD) values of spinal (lumbar 1-4) and femoral (neck) regions measured by both DXA and QCT were evaluated. Results: Spinal and femoral T-scores and BMD values measured by DXA and QCT were similar between the groups (P>0.05 for all). In Group 1, lumbar BMD value, lumbar and femoral neck T-scores measured by QCT were significantly lower than DXA (P<0.001, P=0.004 and P=0.037, respectively). In Group 2, lumbar BMD value and T-score measured by QCT were significantly lower than DXA (P<0.001 and P<0.001). In Group 3, lumbar T-score, lumbar and femoral neck BMD values measured by QCT were significantly lower than DXA (P<0.001, P<0.001 and P=0.004, respectively). Conclusion: QCT is an effective method that can be used in elderly patients with fractures and arthrosis where DXA may yield false-positive results.

Keywords

• Geriatrics
• Ostoeporosis
• Vertebral Fractures
• Bone Density
• DXA
• QCT

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