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Bone densitometry of proximal femur in Chinese subjects: gender differences in bone mass and bone areas.

Bone mineral content (BMC), bone areas (BA), and bone mineral density (BMD) of the proximal femur were measured in 202 healthy Chinese men and 507 healthy Chinese women, aged 21-70 years, to investigate gender differences in densitometry of the femur. Densitometric values measured at the femoral neck, trochanter, and Ward's triangle were generally greater in men than women of the same age, except at Ward's triangle. While BMD decreased with aging with similar slopes of -0.2 approximately -1% per year, the actual readings were 10%-15% lower than those of Caucasian subjects of the same age and gender for Chinese men and women. Furthermore, with increasing age, trochanteric BA increased in women but not in men, and femoral neck BA increased in men but not in women. These different trends of change in bone dimensions were independent of weight or height. They may reflect a structural difference at the proximal femur and imply differences in mechanical strength, and thus may have played some roles in the different incidence of hip fractures between the elderly men and women.

Absorptiometry, Photon↗

CT lung densitometry in assessing intralobular air content. An experimental and clinical study.

PURPOSE: To introduce a parameter called "intralobular air content percentage" to replace the CT number of the lung and to establish a proper protocol for its assessment. MATERIAL AND METHODS: We calibrated the HU (Hounsfield unit) scale for low densities with foam and evaluated the influence of certain acquisition and reconstruction parameters on the accuracy of CT densitometry of the lungs. The reproducibility of the results obtained in human experiments and the intralobular air content percentage of normal and diseased lung tissue were assessed. RESULTS: Air content could be reliably derived from the calibrated CT number of an area within a secondary lobulus. The mean intralobular air content of normal lungs varied from 77.8% to 88.0% in full inspiration. Helical or axial recording with a 10-mm slice thickness, a standard or soft algorithm and high tube currents and voltage settings, was suitable for the measurements. CONCLUSION: Before absolute lung density measurements (as a HU number or an air content percentage), the CT equipment has to be calibrated for low densities. The intralobular air content percentages of cooperative patients were reliably reproducible.

Absorptiometry, Photon↗

Influence of heterotopic ossification of the hip on bone densitometry: a study in spinal cord injured patients.

OBJECTIVE: To evaluate (1) the magnitude of falsely elevated bone density results caused by heterotopic ossification (HO) around the hip and (2) effect of age of patients when the measurement was taken, age of patients at injury, and age of injury (time since event) to the prevalence of HO. SUBJECTS AND METHODS: We blindly analyzed plain radiographs of the hip [(obtained within 1 month of dual energy X-ray absorptiometry (DEXA)] in 107 spinal cord injured (SCI) patients for HO and matched the result to the three regions of interest (ROI): the femoral neck, Ward's triangle, and the trochanter. The influence of HO on bone densitometric values was determined by the analysis of variance (ANOVA) and post-hoc analysis. RESULTS: Nineteen (18%) patients had HO; overlying the femoral neck (79%), trochanter (74%) and Ward's triangle (37%), respectively. Significant elevation of densitometric values (P < 0.05 or less) was observed in a various magnitude at each ROI, with the greatest elevation at Ward's triangle. The prevalence of HO was high when the patients were injured at age range of 20-39 years. CONCLUSIONS: HO around the hip can cause significantly elevated bone densitometry results at all ROIs, which can obscure underlying osteoporosis, leading to underestimation of fracture risk. Determination of bone density in this region with corresponding plain radiographs would be of help. In SCI patients, prevalence of HO was high when the age of patients at injury was 20-39 years.

Absorptiometry, Photon↗

Calcaneal ultrasonometry in patients with Charcot osteoarthropathy and its relationship with densitometry in the lumbar spine and femoral neck and with markers of bone turnover.

AIMS: To assess calcaneal ultrasonometry in Charcot osteoarthropathy (CO) and to compare it with densitometry measured by dual energy X-ray absorptiometry (DEXA) and with bone remodelling markers. PATIENTS AND METHODS: A group of 16 diabetic patients in the acute stage of CO with a mean age (+/- SD) of 51 +/- 13 years was compared with 26 sex- and age-matched control subjects. Both calcaneal quantitative ultrasound (QUS) parameter stiffness and bone mineral density (BMD) measured in lumbar spine and femoral neck by DEXA were compared. Collagen type I cross-linked C-telopeptides (ICTP) were used for assessment of bone resorption. RESULTS: Patients with acute CO had significantly lower stiffness of the calcaneus in the Charcot and non-Charcot foot (both P < 0.001) and significantly lower femoral neck BMD (P < 0.05) in comparison with the control group. The T-score of stiffness was significantly lower in the Charcot foot compared with the non-Charcot foot (-3.00 +/- 1.39 vs. -2.36 +/- 1.12; P < 0.01) and significantly lower than the mean T-score of BMD in the lumbar spine (-0.57 +/- 1.28; P < 0.001) and femoral neck (-1.58 +/- 1.24; P < 0.05). A significant difference in ICTP (8.49 +/- 4.37 vs. 3.92 +/- 2.55 ng/ml; P < 0.001) between patients with CO and the control group was found, and a significant correlation was demonstrated between ICTP and the T-score of stiffness (r = -0.73; P < 0.01). CONCLUSION: The lower calcaneal QUS parameter stiffness in the Charcot foot in comparison with the control group, with the non-Charcot foot and with BMD in the lumbar spine and femoral neck, and its association with increased bone resorption indicate that calcaneal ultrasonometry may be useful in diagnosing the acute stage of CO and in assessing the risk of foot fracture. Diabet. Med. 18, 495-500 (2001)

Absorptiometry, Photon↗

Bone loss in long-term renal transplantation: histopathology and densitometry analysis.

BACKGROUND: There is little information of the spectrum and factors implicated in the bone loss in long-term renal transplantation, and virtually no data using both histomorphometric and densitometric analysis. METHODS: Twenty-three males and 22 females (13 postmenopausal) were studied with a bone biopsy and densitometry. Sixteen patients were on cyclosporine A monotherapy, 20 on azathioprine + prednisolone, and 9 on cyclosporine A + prednisolone or triple therapy. The mean time after transplantation was 127 +/- 70 months. RESULTS: No group had a significant decrease in bone mineral density (BMD) of the axial skeleton compared with an age- and sex-matched normal population. Compared with sex-matched young controls, osteopenia was observed in all groups at the femoral neck (except premenopausal women and triple therapy) and in the triple-therapy group at the L1-L4 spine region. At the distal radius, osteopenia was found in all the groups. Histopathological diagnosis was mixed uremic osteodystrophy in 46.5%, adynamic bone in 23.2%, hyperparathyroid disease in 13.9%, and normal bone in 16.3%. The diagnosis was not different according to immunosuppressive therapy, but men tended to show more mixed uremic bone disease. There was no significant difference in BMD between histopathological subtypes. In general, patients showed slight osteoclast function increase, osteoblast function decrease, and marked retardation of dynamic parameters. The cyclosporine A monotherapy group had a significantly lower appositional rate than azathioprine + prednisolone. Men had a significantly lower bone volume than women, and premenopausal women had a significantly lower mineralizing surface than postmenopausal women and men. In the multivariate analysis, male gender, time after transplantation, old age, and time on dialysis prior to transplantation were significant predictive factors for a negative effect on bone mass. CONCLUSIONS: Long-term renal transplant-patients showed reduced BMD in both trabecular and cortical bone. This reduction in BMD was not as severe as in short-term reports and was associated with osteoclast stimulation, osteoblast suppression, and retardation of mineral apposition and bone formation rates. Bone mass loss was not different between the immunosuppression therapy groups. Male gender and age were the strongest predictive factors for low bone mass.

Absorptiometry, Photon↗

Augmentation of intraarticular calcaneal fractures with injectable calcium phosphate cement: densitometry, histology, and functional outcome of 18 patients.

Eighteen patients with intraarticular calcaneal fractures treated with open reduction and internal fixation and augmentation with an injectable carbonated apatite cement. Functional follow-up studies using the Zwipp Foot Score and densitometry were performed at 6-month intervals postoperatively. Histological samples of biopsies obtained at the time of hardware removal (6 months postoperatively) were also analyzed. The use of bone cement led to intermediate-term functional outcomes that were no better than those reported with conventional surgical procedures using bone graft. Patients demonstrated postoperative difficulties similar to those seen in other studies of this fracture, including pain, subtalar motion restrictions, peroneal impingement, and difficulties on uneven terrain and with toe- and heel-walking. However, compared to patients treated surgically without injectable carbonated apatite cement, full weight bearing on the affected extremity was regained at an average 4 weeks postoperatively. In addition, autogenous bone graft was not required to fill the osseous defect using this technique, minimizing morbidity and discomfort. During the present observation period of 3 years, only a slight decrease in the density of the peripheral zones of the cement block was observed. Histological examination revealed fibrous bone formation resulting from remodelling processes. Complete resorption and remodeling of the bone cement were not complete at 3 years. One patient developed a postoperative wound infection. Another displayed cement loosening secondary to failure of bony ingrowth.

Adult↗

[New principles and theories for improving angio-cinedensitometry. I. The physical principles of quotient densitometry(author's transl)].

The physical basis of quotient densitometry is described. All stages are discussed, beginning with the production of the x-rays, their attenuation by the patient, their effect on the radiographic film, and the evaluation of the film by projection and its measurements by a photo cell in a Wheatstone bridge. Two values were obtained, one consisting of the signal together with background fog, the other of the background alone. By an analysis of the relationships of these measurements, obtained from specially separated points on the radiograph, it is possible to eliminate artefacts to a large extent.

Absorptiometry, Photon↗

[The dorsum sellae as an indicator of axial skeletal osteoporosis. The results of computer tomographic densitometry].

Computer tomographic densitometry of the dorsum sellae shows decreasing density with increasing age. This reduction does not take place evenly, but increases markedly at the age of 50. Densities below twice a standard deviation of mean values suggest that there is porosis of the axial skeleton as well. This provides an interesting and useful piece of additional information during cranial computed tomography.

Adult↗

[The value of scintimetry compared with histomorphology, parathormone assay, densitometry and radiology in renal osteopathy (author's transl)].

The distribution of 99mTc-Sn-MDP in the thigh was estimated according to two different indices in 60 normal patients, 21 patients undergoing haemodialysis and one who had had a renal transplant. Deviation of the indices in these patients from the normal are significant. The indices were correlated with respect to their accuracy in detecting renal osteopathy with histomorphometry (as the reference method), radiological diagnosis, densitometry, parathormone assay and other laboratory tests. Accuracy of the method is high and, like histomorphometry, is over 90%.

Absorptiometry, Photon↗

Survey of the natural occurrence of zearalenone in maize from northern Iran by thin-layer chromatography densitometry.

During September 2000, forty samples of preharvest maize from the province of Mazandaran, north Iran, were randomly collected. Samples were analysed for zearalenone (ZEA) by a thin-layer chromatography (TLC) method (AOAC Official Method). ZEA was extracted with chloroform, purified through a chromatographic column containing silica gel, separated on a TLC plate and quantified by densitometry. The analytical method was validated and was adequately reliable and sensitive. The mean recovery rate of ZEA from spiked samples was 92%. The absolute amount of ZEA standard detectable on a TLC plate was 20 ng, giving a limit of detection (LOD) of 100 ng g(-1). In some samples, it was shown that aflatoxins interfere with ZEA. Therefore, to remove this interference, the TLC mobile phase was changed. Data revealed that three of 40 (7.5%) maize samples contained ZEA in the range 100-212 ng g(-1), with a mean of 141+/-51 ng g(-1). This study, which is the first report of ZEA occurrence in Iranian maize, showed that the ZEA level in maize of Mazandaran province was lower than maximum limit for this mycotoxin in Iran.

Chromatography, Thin Layer↗

Dual-energy X-ray absorptiometric densitometry in osteoarthritis of the hip. Influence of secondary bone remodeling of the femoral neck.

PURPOSE: The aim of this study was to evaluate the influence of buttressing on bone densitometry measurements in the femoral neck, in Ward's triangle, and in the greater trochanter. In addition, we attempted to establish the length of the femoral axis (FAL) and the true length of the femoral neck (FNL) as potential correlates with osteoarthritis (OA) or with buttressing. MATERIAL AND METHODS: Our study comprised 101 hips in 68 adult patients. Conventional radiographs of the hip joints were obtained in order to assess the presence and extent of OA by means of the 6-step grading system introduced in 1990 by CROFT et al., and in order to measure the cortical thickness at the medial aspect of the femoral neck. In addition, FAL and FNL were measured. All patients underwent dual energy x-ray absorptiometry so that bone density could be assessed in the femoral neck, in Ward's triangle, and in the greater trochanter. The Spearman rank correlation was used to compare the measurements. RESULTS: Statistical analysis showed a significant positive correlation between cortical thickness and bone density in the femoral neck and in Ward's triangle. No correlation was found between cortical thickness and bone density in the greater trochanter, nor between cortical thickness and OA, FNL, and FAL, nor between OA and bone density, FNL, and FAL. CONCLUSION: Buttressing influenced our bone density measurements in the femoral neck and in Ward's triangle. It did not affect the region of the greater trochanter which may therefore be the best region of interest for a long-term follow-up of bone density in patients with OA.

Absorptiometry, Photon↗

Changes in metacarpal bone mineral density with age and menopause using computed X-ray densitometry in Japanese women: cross-sectional and longitudinal study.

BACKGROUND: Bone mineral density (BMD) loss with age and menopause is widely accepted in elderly women. However, only a few studies have utilized a multiple regression model that includes physical characteristics to assess comprehensive lifetime changes in BMD. OBJECTIVE: A prospective study was conducted to characterize the normal patterns in metacarpal BMD changes in Japanese women, and to assess the applicability of a fitting model using cross-sectional data compared with longitudinal variability. SUBJECTS AND METHODS: The study consisted of 5422 healthy women in cross-sectional data and a 1-year follow-up of 359 women. The metacarpal BMD was measured by computed X-ray densitometry. Multiple linear and nonlinear regression analyses were performed in cross-sectional subjects. Nonparametric analysis was used to compare percentage rates of BMD changes between actual and estimated values. RESULTS: The cross-sectional data showed that the best-fit equation was a nonlinear change model using the variables of age and height in premenopausal women, and years since menopause (YSM), age and height in postmenopausal women. The results of longitudinal data indicated the following. In premenopausal women, the actual BMD changes were greater in the 30-39 age group than the 20-29 age group and were less in the 50-59 group than the 40-49 group. The rates of annual change in BMD between the actual value and estimated value by change model were very similar. In postmenopausal women, the actual changes in BMD indicated that the rapid rate of reduction observed was over 3% at 0-5 YSM and 1.5% at 6-10 YSM, and thereafter showed a slower rate of decline at 11 YSM. The change model represented the trend of actual change in BMD for postmenopausal women, whereas the rates of estimated BMD loss underestimated the actual changes at 1-10 YSM. CONCLUSION: The change model for premenopausal women using cross-sectional data is beneficial in evaluating the actual metacarpal BMD variability, whereas that for postmenopausal women is insufficient in estimating the longitudinal BMD variability.

Adult↗

Quantitative densitometry of autoradiograms: digital images representative of optical density.

Microcomputer software has been developed to control video acquisition of 1024 x 1024 digital autoradiogram images which represent true optical density (OD). Since video cameras are sensitive to intensity (I), background correction and conversion to OD must be accomplished in software. The software linearizes camera output against an optical step tablet of known ODs and creates a 'look-up table' through which captured images are passed. This procedure allows the accurate and rapid conversion of a large number of images. The user is directed through the calibration and capture procedures; safeguards are included to ensure that the resultant images are correctly calibrated. The algorithms used in these programs accommodate the limited computing power available in microcomputers. The use of a commercially available graphics library will enhance the portability to multiple hardware configurations. This software is a low-cost alternative for the capture of digital images needed for quantitative densitometry.

Absorptiometry, Photon↗

Determination of polycyclic aromatic hydrocarbons in environmental samples by high performance thin-layer chromatography and fluorescence scanning densitometry.

High performance thin-layer chromatography (HPTLC) with fluorescence scanning densitometry was used for the quantitative determination of polycyclic aromatic hydrocarbons in the soluble organic fraction of air particulate samples. A method using normalized emission response ratios was developed to determine sample identity and to test for peak homogeneity. To preserve the high sample throughput of HPTLC, the two-point calibration method was used for quantitation. The principal advantages of HPTLC as a screening technique for environmental samples are its low cost, methodological simplicity, high sample throughput, and the ability to analyze crude samples with a minimum amount of sample cleanup.

Air Pollutants, Occupational↗

An open access bone densitometry service: report of first year's operation.

Medical treatment of symptomatic osteoporosis is unsatisfactory. Treatment of patients with low bone density but without history of fracture includes hormone replacement therapy (HRT) which offers the prospect of reduced fracture risk. Dual energy X-ray absorptiometry (DXA) offers a safe and accurate technique available for the measurement of bone mineral density at a district general hospital level. All open access service providing densitometry measurements for general practitioners and hospital consultants was instigated at South Cleveland Hospital in February 1991. A major purpose of the service was to provide density measurements in order to 'inform' the discussion between the patient and doctor with regard to the use of anti-resorptive and other medical agents. We report our experience of operating such a service. The report analyses the main reasons for referrals. Nine hundred and thirty female subjects and 63 male subjects were scanned. The main reason for female referral were early menopause, consideration for HRT, personal history of fracture and family history of fracture--these account for 54.7% of all referrals. In men, there was a high incidence of fracture, back pain and the use of steroids given as reasons for referral. Sixty-seven per cent of patients were referred by general practitioners. Eighteen per cent of female lumbar spinal BMD values were between 1 and 2 S.D. below the Leeds normative mean and 9.0% below 2 S.D. Figures for the femoral neck were 22.0 and 9.0%.(ABSTRACT TRUNCATED AT 250 WORDS)

Absorptiometry, Photon↗

Increased bone mineral density in dual x-ray densitometry due to gluteal implants.

The results of dual x-ray bone densitometry in a patient with bilateral gluteal implants are presented. The patient underwent three measurements of the spine and hips, and one of them was before surgery. A baseline study showed mild osteopenia. After surgery, bone mineral density increased in both femoral necks, because of the superimposition of the implants. A spine phantom with and without a similar implant reproduced the findings in the patient. It is important to consider this type of surgery as a cause of potential bone mineral density artifact.

Absorptiometry, Photon↗

A postprocessing dual energy technique for vertebral CT densitometry.

The influence of the fat content in the cancellous bone on CT densitometry was measured on the excised vertebrae from 42 elderly human subjects. Using single energy CT, the decrease of the measured mineral content was 12% for a fat content of 10% by volume at a mean mineral content of 100-110 mg/cm3. Using a dual calibration at 85 and 130 kVp with reference to K2HPO4 for mineral and to alcohol for fat, our experiment showed that the mineral content of the vertebra can be measured with an accuracy of 6% referred to the ash-weight.

Absorptiometry, Photon↗