Терапевтический архив (Mar 2009)
Outpatient dual-energy x-ray osteodensitometry in diagnosis of early disorders of mineral bone density and monitoring of postmenopausal osteoporosis treatment
Abstract
Aim. To improve quality of densitometric diagnosis of abnormal bone tissue mineral density (BTMD) in postmenopausal women using the results of densitometry of two adjacent lumbar vertebra and proximal regions of both femoral bones. Material and methods. Densitometry (dual-energy x-ray absorptiometry) was made on densitometer Lunar Prodigy in 7731 women: 969 under 50 years of age, 3081 - aged 50-65 years (early postmenopause) and 3681 - aged 65 years and older. BTMD data were analysed with the system MEDIALOG. Results. In postmenopause metabolic disorders of bone tissue are detectable with a standard analysis of the results of dual x-ray osteodensitometry in about 2/3 (72.14%) patients (at the stage of osteopeny in 33.13% and osteoporosis - in 39.01%). Diagnostic efficiency in consideration of the T-criterion in the adjacent lumbar vertebra in comparison to the integral value LI-LIV rises in 50-65 year old women in osteoporosis by 7.27% and in osteopeny - by 8.31%; in women over 65 years of age by 10.11 and 3.62%, respectively. Diagnostic value rises in comparison of the results of bilateral examination of the femoral bones with the results of unilateral (left-sided) investigation in women over 50-65 years in osteoporosis by 1.46%, osteopenia - by 1.10%, in women over 65 years - by 3.51 and 2.26%, respectively. Densitometric picture is not permanent, osteoporosis runs in 2 stages. Conclusion. For early diagnosis of postmenopausal osteoporosis most informative is the analysis of BTMD by three areas: lumbar spine LI-LIV, adjacent vertebra LI-LII, LII-LIII, LIII-LIV and necks of both femoral bones.
