The British Journal of Rheumatology, Vol 37, 496-501, Copyright © 1998 by British Society for Rheumatology
C Chappard, S Kolta, J Fechtenbaum, M Dougados and C Roux
A new method for vertebral height measurements, morphometric X-ray
absorptiometry (MXA) based on dual-energy X-ray absorptiometry, has been
proposed. This technique overcomes some limitations of morphometric
radiography (MRX): the effective radiation dose is low, some sources of
geometric distortion are eliminated, such as dependence on patient
position, magnification gradient, and the effect of scoliosis is minimized.
The purpose of this study was to compare morphometric parameters obtained
by both methods (MXA and MRX), and to evaluate the agreement between
morphometric evaluations and qualitative reading for vertebral fracture
diagnosis. The evaluation was performed with an Hologic QDR 2000 device in
67 women without vertebral fractures and 31 women with vertebral fractures
(according to a qualitative assessment). The reproducibility of the image
analysis was <4% and comparable to MRX. The estimated bias between the
two methods was on average 10 mm, and was a function of the vertebral
height, according to the Bland and Altman method. The agreement between MXA
and other methods for vertebral fracture diagnosis was poor for the
thoracic level above T7, due to a lack of resolution and rib interposition.
Agreement was also low for T10, due to the motion of the diaphragm muscle.
MXA cannot currently be used for the diagnosis of thoracic vertebral
fracture in clinical practice. Technological improvements are necessary to
make this promising method useful as a screening tool to evaluate the
presence of thoracic vertebral fractures.
ORIGINAL PAPERS
Clinical evaluation of spine morphometric X-ray absorptiometry
Centre d'Evaluation des Maladies Osseuses, Hopital Cochin, Paris, France.
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