Densitometry. What is it, ultrasound bone, x-ray, ultrasound, CT. How to prepare, conduct research, where do the price. Decoding results in bone density

Over the years, the bone loses calcium and osteoporosis develops. Densitometry - a chest X-ray that gives doctors information on changes in bone density.

For suspected osteoporosis or the presence of its possible development factors doctors prescribe densitometry every 2 years. This approach gives physicians the opportunity to see the development of osteoporosis in the early stages, to start early treatment to prevent fractures.

What is densitometry

Densitometry - it is inspection which determines the mineral content of bone tissue, the presence of calcium compounds. The trauma often studied peripheral parts of the fracture site, but according to information received, doctors see the clinical picture of the general condition of the bones throughout the body.

Elderly people suffering from complications after fractures of the slow merging of fragments. Therefore, it is important to early diagnosis using densitometry. It helps to prevent osteoporosis education.

Indications for study

Osteoporosis occurs in people of all ages, not just older. State, reducing the level of calcium in the blood are varied. But they all affect the density and strength of bone tissue.

Indications for the study are:

• dysfunction of parathyroid disease and its development; gipoparatireoze reduced activity gland secretion diminishes synthesis - parathyroid hormone, which is responsible for receiving bone tissues calcium, reducing its output renal system;
• injury, accompanied by bone fractures;
• continuous treatment with drugs having the property to lower the calcium content; These include a steroid-type hormones, oral contraceptives, diuretics - Furosemide, Torasemide, drugs against seizures - phenobarbital, carbamazepine;
• consumption of alcoholic beverages in step alcohol addiction disorders;
• women over 40; men older than 60;
• patients older than 30, when a family member is diagnosed osteoporotic disease;
• people move a little;
• women who follow a diet to lose weight;
• patients who work in the production of high physical exercise;
• dynamic observation of the patient during treatment to assess the effectiveness of therapy chosen direction.

Densitometry for women - is an important examination. Women are at risk for calcium loss due to fluctuations in production of the female hormone - estrogen, so for them there is an additional list of assignments to conduct such a procedure.

This is the situation:

• menopause (check the status of the bones is important for early onset of her, up to 45 years);
• after adnexectomy operations hysterectomy.

Densitometry - it is a survey that gives the physician the necessary information on the state of the patient's bone tissue.

Contraindications and limitations

Densitometry - it is a gentle examination, contraindications which is not seen. But the use of X-ray radiation contraindications still has.

Research on X-ray units with surveys are not available:

• the apparent scoliosis;

  

• the apparent curvature of the vertebral bone;
• when a hip joint prosthesis;
• after surgery with a compound of the bone fragments with metal pins;
• in diseases of dystrophic joints;
• with a weight above 110 kg person;
• if patient's height above 195 cm;
• when a person has heart pacemakers, metal implants.

Densitometry - it is a serious examination, during which a woman and a growing fetus may get unwanted exposure. Therefore absolute contraindication examination with X-rays is given to pregnant women.

Equipment for investigation

Medical Devices Survey bone represented by two devices:

• US-densitometers using ultrasonic irradiation;
• X-ray densitometers with X-ray irradiation.

Advantages of ultrasonic devices:

• safety inspection;
• rapid survey;
• compact and mobile devices;
• There is a computer with special software programs;
• survey possible in any room;
• democratic apparatus cost.

UZI densitometer does not provide the most accurate information.

Commonly used model UZI densitometers:

• apparatus Sonost 3000, Korean-made: in the equipment has a monitor and thermal printer, an interface based on the latest Windows models;
• apparatus McCue CUBA Clinical, manufactured in the USA: has a high accuracy inspection may be connected to a computer with the printer with a special program;
• apparatus Omnisense 7000, Israeli-made: in the equipment - screen, the main unit, the probes to survey the different bones.

Advantages of X-ray densitometers:

• high-precision measurement;
• Direct examination of the hip joint;
• lumbar examination, the most accurate method of determining the presence of osteoporosis;
• inspection departments of large bones.

Cons devices:

• patients receive x-ray exposure;
• It requires a special room for the installation of the device;
• expensive price of X-ray densitometer.

The most popular models of X-ray equipment:

• Installation Norland ELITEManufactured by Norland Medical Systems: the largest machine in the world, equipped with modern software;
• Installation Norland XR46, The production of the same company: provides accurate measurements with calibration masses of different tissues have positioning system with a rotation angle;
• Installation LUNAR iDXA: In the equipment has a program for examination of children, the study of the body index, analysis of bone tissue;
• DEXXUM device 3 production of South Korean company OsteoSys conducting a study on the method of dual energy absorptiometry, an important advantage - the software in Russian.

X-ray and ultrasound densitometers different production successfully used in major diagnostic centers, medical offices to large industrial enterprises. Their choice and range of prices makes it possible to obtain a medical facility, such a device, which will suit the needs of the enterprise, city, region.

types densitometry

The study was conducted by special devices - densitometers.

They differ in the method of the results:

• ultrasound; for this purpose portable devices using a method of studying UZI wave transmission rate of bone tissue;
• X-ray absorptiometry; the most frequently used technique, which gives an image on X-ray images, where areas of different densities clearly visible; phones are two-photon-photon and to study different parts of the body;
• scintigraphy;
• MRI;
  
• dual-energy CT, a three-dimensional analogue of DXA;
• CT, QST-densitometry;
• multislice CT, MDCT.

These latter techniques are rarely carried out because of their high prices.

ultrasound densitometry

Ultrasound densitometry - the study of mineralization of bone tissue, which is performed in a manner of indirect passage of radiation. UZI wave goes through the bone tissue with a different density, a different rate.

The device transmits ultrasound at a specific frequency for a predetermined portion of the bone survey indicators catches sensor output.

Data obtained from a low information content, however, the device is used frequently. This is due to the security and speed of research.

X-ray densitometry. CT densitometry

X-ray apparatus method explores these doctors bone portion having the program calculates the level of mineralization of bone tissue.

Today, developed and used different ways to x-ray densitometry:

• Dual Energy; technique is based on the passage of the two X-ray beams - the first is the bones, the second - on the soft tissues; then compare the performance of their progress; analysis is made on general principle - if bone mineralization is high, the low permeability of the rays; this method is usually examined the spine and hip bones;
• peripheral densitometry; It uses the same measurement principle, but the patient receives less radiation dose; this method is estimated indicators of bone tissue, is also used to monitor treatment.

CT densitometry also uses exposure to ionizing radiation. CT gives a picture of the bones in the volume. It is rarely used because of the high ionizing radiation, and high inspection rates.

The indications for CT examinations are:

• long-term use of hormones;
• lingering inflammation in the digestive tract;
• cystic fibrosis lung and gastrointestinal nature;
• connective tissue disease;
• lung and kidney dysfunction;
• Dysfunction in the gonads, the lack of production of sex hormones;
• genetic diseases of the musculoskeletal system.

Bone densitometry carried out CT, gives physicians indicators of decline in bone volume at the beginning of the development of pathology. This is a good technique for early diagnosis of the disease.

Alternative diagnostic methods

Alternatively, one can consider the survey:

• photon absorptiometryWhere the survey is conducted photon beams; they pass through the bone tissue, and the calculation of the mineralization is carried by absorption of photons as they pass through the tissue; here applies low exposure;
• x-ray computed tomography - CT.

There are 2 types of photon absorptiometry:

• monochrome; It applied to the study of mineralization peripheral to the bones;
• dihromnaya; It is used to obtain data on the mineralization of bones in the spine and hips.

Photon absortsimetriya gives gentle irradiation, and at the same time shows the exact results of the study. At the same scan it is much faster than testing for X-ray machines.

CT-examination principle is to pass through the patient's body is x-ray fan-beam focused on the same projection.

When the beam passes through dense tissue, their intensity decreases, it registers a special detector. Determines bone density program based on a mathematical integration. When does a computer analysis, the program builds a tomographic image in several projections.

Training

To get from the survey on densitometry objective results, it should be:

• in the case where the last 2 weeks, a survey of other organs with contrast, I must say it is the physician;
• the existence of pregnancy, even in the first week, it is necessary to tell your doctor;
• get dressed so that it's comfortable to lie without moving for 15 minutes;
• remove metal objects, gold chains, earrings, as they may affect the outcome;
• a day or two prior to the survey stop taking drugs with calcium, including Vitrum, Kaltsinova.

We must adjust itself to holding fixed positions, said a doctor, set for the examination time is usually 30-40 minutes.

How is the densitometry

Densitometry is performed in a specially equipped room. If the ultrasound scan densitometry, the patient lies on a couch in the unit. Ultrasound examination uses sensors that are worn on the patient finger. 3-5 min passes ultrasound waves to study the movement of the bone tissue.

When the survey is carried out on X-ray machine, the patient lies on the examination table, the operator checks the position, fix it and asked to stay in a given position the required number of time. Under the table is a plane source of radiation over the patient - the device that writes the results of the study.

Reading data sensor is moved over the body, measures the rate of passage of radiation transmits data to the computer. Here the results are processed, analyzed. Result is obtained in the form of x-ray images.

If the study is held on the installation with a single unit, the specified part of the body is placed in the machine, the results issued by a computer program. Often, to improve the quality of the image, part of the body is fixed with additional fasteners.

When the x-ray image is transferred to a computer, where software analyzes. The procedure continues from 10 minutes to ½ hour, depending on the survey volume.

That shows densitometry. Decoding results

Densitometry shows:

• microarchitectonics bone tissue;
• mineralization;
• microdamages on bone beams.

As a rule, investigated parts of the spine and hip joints. According to the testimony study estimated the overall bone structure. Interprets the results of densitometry software algorithm.

There are important examination 3 parameters:

• Bone tissue density, Unit - g / cm2; This classic SD indicators, or in Russian written CO, which means the same thing as a percentage of the regulations. Each unit of divergence from standard doubles the risk of osteoporotic fractures;
• T-valueAnalyzed as a statistical hypothesis; the results obtained are compared with standard data mineralization;
• Z-dataStandardized; compared the results of the T-studies with standard data for healthy people.

T- and Z- data has a standard rating scale to help doctors assess the condition of the bone tissue in a human subject:

1. Indications from 0 to -1.5 is considered normal.
2. Indications from -1.5 to -2.5 point to a density decrease, diagnosed as osteopenia.
3. Indications below -2.5 indicate osteoporosis formed.

Z index values ​​are treated differently for children and adults:

• women in the period before menopause, bone density is estimated at below normal Z;
• men up to 50 years low levels of tissue density is estimated at Z as a significant decrease in age-related standards;
• children and adolescents with Z diagnosed pathology of bone tissue.

Modern densitometers have pledged to base performance norms for age, sex. The program compares the received data and decodes the result.

In pediatric diagnosis of "osteoporosis" is not established on the basis of densitometry, because bone mass is not formed completely. The process ends only to 25 years of age. It is taken into account and the fact that Z and T parameters slightly change after 45 years of decline of 13-15% is not the basis for diagnosis. This requires further examination.

The price of different types of research

Prices for osteoporosis studies by different methods vary by the type of health care facility, planned or emergency inspection. Public hospitals for all kinds of examinations set prices cheaper than private medical centers. In particular prices depend on the level of the center, its popularity.

Survey tab is less than the carrying out of scanning directly when handling. Survey on cost influences specialist qualifications, the availability of additional services.

Screening to determine the lesion of bone in the spine, femur MRI costs about 15 thousand rubles., If you conduct research without a doctor's referral.

Price trend - 14 250 rubles. There are benefits for the disabled, pensioners, health care workers, children up to 12 years, affected by the Chernobyl accident, blockade, war veterans. For them, the prices vary between 12-13 thousand. rub.

Ultrasound densitometry - it is tested for these different devices, which is estimated in different cities in different ways.

On average, it costs from 622 rubles. 2 Survey places to 700 rubles. for the 1st place. In different cities of the country prices are set differently. For example, in Voronezh for examination 6 places the patient will pay 845 rubles in Moscow in different centers to explore the 175 seats, the average price -. 2205 rubles.

Registration of the article: Lozinski Oleg

Video of the densitometer

What is densitometry, as it is done: