Journal of the Korean Society of Radiology (대한영상의학회지)

The Korean Society of Radiology (대한영상의학회)
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Feasibility of Peripheral Bone Densitometry for the Assessment of Bone Density: Comparison with Dual Energy X-ray Absorptiometry of the Axial Skeleton

골밀도 측정에 있어서 말단부골밀도측정법의 유용성: 중축골 이중에너지방사선흡수법과의 비교

  • Park, Ji-Seon (Department of Radiology, Kyung Hee University Medical Center) ;
  • Jin, Wook (Department of Radiology, East-West Neomedical Center, Kyung Hee University) ;
  • Park, So-Young (Department of Radiology, East-West Neomedical Center, Kyung Hee University) ;
  • Bae, Min-Sun (Department of Radiology, East-West Neomedical Center, Kyung Hee University) ;
  • Kim, Doeg-Yoon (Department of Nuclear Medicine, Kyung Hee University Medical Center) ;
  • Choe, Bong-Keun (Department of Preventive Medicine, School of Medicine, Kyung Hee University) ;
  • Ryu, Kyung-Nam (Department of Radiology, Kyung Hee University Medical Center)
  • 박지선 (경희대학교 경희의료원 영상의학과) ;
  • 진욱 (경희대학교 동서신의학병원 영상의학과) ;
  • 박소영 (경희대학교 동서신의학병원 영상의학과) ;
  • 배민선 (경희대학교 동서신의학병원 영상의학과) ;
  • 김덕윤 (경희대학교 경희의료원 핵의학과) ;
  • 최봉근 (경희대학교 의과대학 예방의학과교실) ;
  • 류경남 (경희대학교 경희의료원 영상의학과)
  • Received : 2009.09.14
  • Accepted : 2010.01.14
  • Published : 2010.06.01
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Abstract

Purpose: To evaluate the feasibility of peripheral bone densitometry for the assessment of bone density, and to compare it with dual energy X-ray absorptiometry (DXA). Materials and Methods: Radiographic absorptiometry (RA) of the middle phalange, peripheral DXA (pDXA) of the calcaneus, and the DXA were performed for two groups: Group 1 was a normal group of 54 healthy young women and group 2 was a group of 54 postmenopausal women considered to be at a high risk for osteoporosis. For the normal group, RA and pDXA were scanned twice to assess the repeatability of the methods. The Tscores were compared to determine whether there was a correlation between the peripheral and axial bone densitometries. The cutoff values of RA and pDXA for the diagnosis of osteopenia were determined. Results: Each examination showed different T-scores for a given person. The T-scores of RA were higher than those of pDXA for the normal group, whereas the T-scores of pDXA were higher for high-risk group. The coefficients of repeatability were 0.88 in RA and 1.53 in pDXA. The correlation coefficient for DXA was higher in RA than in pDXA. The cutoff values for osteopenia were -1.773 for RA and -1.75 for pDXA, as compared to -1.0 for DXA. Conclusion: The data suggests that RA is a viable screening method for osteoporosis. However, there should be consideration for the fact that bone density depends on examination methods or sites.

목적: 골밀도 측정에 있어서 말단부골밀도측정법의 유용성을 알아보고, 이중에너지방사선흡수법(DXA)과 비교하고자 한다. 대상과 방법: 20~30대의 건강한 여성 54명과 골다공증 고위험군인 50~60대의 폐경기 여성 54명을 대상으로 말단부골밀도측정법인 왼손 세 번째 중지골에 대한 방사선흡수법(RA)과 왼쪽 종골에 대한 말단부 이중에너지방사선흡수법(pDXA)과 함께 표준검사법인 요추부 및 대퇴골에 대한 DXA를 시행하였다. RA와 pDXA는 정상군에서 각각 2회씩 검사하여 반복재현성을 평가하였다. RA와 pDXA의 T-score를 각각 DXA의 T-score와 비교하여 상관관계의 유무를 알아보고, 각 검사법의 골감소증 진단을 위한 T-score 값을 산출해보았다. 결과: 동일인에서 세 가지 검사법은 서로 다른 골밀도 값을 보였으며, 정상군에서 RA가 pDXA 보다 높았고, 골다공증 고위험군에서는 pDXA가 높았다. RA와 pDXA검사법의 반복계수는 각각 0.88과 1.53으로 높게 나타났다. DXA와의 상관관계는 RA법이 pDXA에 비해 높았다(RA, r=0.6067; pDXA, r=0.1693). DXA의 골감소증 진단기준인 T-score=-1.0과 비교해 골감소증의 확정값은 RA에서 -1.773, pDXA에서 -1.75였다. 결론: 말단부골밀도측정법, 특히 RA는 골다공증 선별검사로 유용하게 이용될 수 있으나, 동일인에서 검사 부위나 방법에 따라 골밀도가 다소 다르게 나타날 수 있음을 유의해야 한다.

Keywords

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