淺談骨質疏鬆症之診斷方法

Diagnosis of Osteoporosis

華亦熙(Yi-Shi Hwua) ； 林政勳(Cheng-Hsun Lin) ； 林松水(Song-Shei Lin)

《中華放射線技術學雜誌》 29卷1期 (2005/06) Pp. 81-95

https://doi.org/10.30045/CJRT.200506.0010

摘要

骨質疏鬆症是一種因骨量減少、骨組織微細結構受到破壞的疾病，容易導致骨骼機械能力下降，以及非受創性骨折的發生。臨床上常見的骨折有，脊椎骨折、髖關節骨折、以及腕關節骨折，而其中又以髖關節骨折所造成的影響最為嚴重。骨折的後續，往往會造成患者肢體的不健全、甚至死亡，同時也會大大的增加醫療照顧的成本。在20世紀最後的20年裡，人們最主要的貢獻在於了解骨質疏鬆症的病理與診斷，根據研究顯示，骨質密度決定了大約80%的骨骼強度。如今，除了傳統X光片以外，更增加了許多不同的骨質密度測量儀，來幫助醫生定量患者的骨量。在眾多骨質密度測量技術當中，目前還是以雙能量X光骨質密度吸收測量儀為臨床上最主要的診斷工具，新一代的雙能量X光骨質密度吸收測量儀，更能評估出脊椎因骨折所導致的變形。骨質密度測量儀的發展，在最近10年已漸趨成熟，並成為臨床上診斷骨質疏鬆症的標準程序。放射技術師是臨床上最直接執行骨質密度測量的人，因此，更應了解各種骨質密度測量儀的優缺點，以及它們在診斷骨質疏鬆症、預測骨折風險、與追蹤骨鬆治療成效上的應用。

關鍵字

骨質疏鬆症 ； 診斷 ； 骨質密度測量儀

並列摘要

Osteoporosis is a systemic skeletal disease characterized by low bone mass and microarchitectural deterioration of bone tissue leading to diminished biomechanical competence of the skeleton and tow-trauma or atraumatic fractures: fractures of the spine, hip and wrist are the common clinical complications, with those of the hip being the most serious. These contributes substantially to morbidity, mortality and health care cost. During the last two decades there have been major advances in the understanding of pathophysiology and in the diagnosis of osteoporosis. However, studies have shown that bone mass is one of the most important determinant of bone strength and accounts for up to 80% of its variance. There are now, in addition to standard radiographs, a number of different bone densitometry available to doctors for the quantitative assessment of bone mass. Several techniques are available but dual-energy x-ray absorptiometry (DXA) is the predominant technology. Spine imaging is possible with newer dual-energy x-ray absorptiometry devices for the determination of structural deformities like vertebral fracture. Bone densitometry has matured in the last 10 years to become an integral part of clinical practice, particularly in the evaluation and management of osteoporosis. Radiographers more directly involved with the different modalities used for the quantification of bone mass need to be more aware of the strength and limitations of the different techniques currently available, and these methodologies use in clinical diagnosis, prediction of fracture risk, and monitoring of patients with osteoporosis.

並列關鍵字

Osteoporosis ； Diagnosis ； Bone densitometry