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Densitometrische Methoden zur quantitativen Beurteilung von pathologischen Knochenveränderungen

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Bisphosphonattherapie von Knochenerkrankungen

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Zusammenfassung

Bei der quantitativen Beurteilung des Knochens mit densitometrischen Verfahren werden zwei verschiedene physikalische Eigenschaften des Knochens erfasst: Die Masse des Knochens und die Geometrie bzw. die Größe des Knochens. Fast alle der heutzutage anerkannten densitometrischen Verfahren verwenden zur Bestimmung dieser beiden Eigenschaften Röntgenstrahlung. Dabei macht man sich die röntgenabsorbierenden Eigenschaften des Knochens, die hauptsächlich durch seine mineralische Matrix bestimmt werden, zu Nutze. Die physikalischen Wechselwirkungen zwischen der Röntgenstrahlung und dem Knochen werden durch die Gesetze der photoelektrischen Absorption und der Compton-Streuung beschrieben [1]. Aufgrund dieser Gesetze wird deutlich, dass zum einen die physikalische Dichte die entscheidende Größe für die Schwächung der Röntgenstrahlung in Materie ist und dass Elemente höherer Ordnungszahl (z.B. Kalzium) mehr Strahlung schwächen als Elemente niedriger Ordnungszahl (z.B. Wasser). Diese Tatsachen macht man sich zu Nutze um die Masse des Knochens innerhalb des Strahlenganges einer Röntgenröhre quantitativ zu bestimmen. Die zweite physikalische Eigenschaft, die Geometrie des Knochens, wird über bildgebende Verfahren bestimmt. Jedes auf diesen Prinzipien beruhende densitometrische Verfahren erzeugt daher eine Art digitales Röntgenbild, welches zur Bestimmung geometrischer Daten ausgewertet wird. Bei den absorptiometrischen Verfahren zur quantitativen Beurteilung des Knochens kann man zwischen Verfahren, die eine Flächenprojektion des Knochens auswerten und Verfahren welche eine dreidimensionale Darstellung des Knochens nutzen, unterscheiden. Zu den Flächenprojektionsverfahren zählt man die Ein-Energie-Röntgen-Absorptiometrie (Single X-ray Absorptiometry, SXA) und die Zwei-Energien-Röntgen-Absorptiometrie (Dual X-ray Absorptiometry, DXA). Früher wurden statt der Röntgenquellen noch radioaktive Photonenstrahler eingesetzt. Aus diesen Zeiten stammen die entsprechenden Bezeichnungen SPA und DPA (Single- bzw. Dual Photon Absorptiometry). Das Verfahren, welches eine dreidimensionale Darstellung benutzt, ist die Quantitative Computertomographie (Quantitative Computed Tomography, QCT). Für spezielle Anwendungen im peripheren Skelettbereich stehen auch sogenannte pQCT-Geräte (peripheral Quantitative Computed Tomography) zur Verfügung.

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  1. P. Augat
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Editors and Affiliations

  1. Stiftung Friedrichsheim, Orthopädische Universitätsklinik, Marienburgstr. 2, 60528, Frankfurt/M., Germany

    A. A. Kurth

  2. Orthopädische Klinik III, Annastift, Heimchenstr. 1-7, 30625, Hannover, Germany

    L. Hovy

  3. An den Schulwiesen 35, 63263, Neu-Isenburg, Germany

    T. Hennigs

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Augat, P. (2001). Densitometrische Methoden zur quantitativen Beurteilung von pathologischen Knochenveränderungen. In: Kurth, A.A., Hovy, L., Hennigs, T. (eds) Bisphosphonattherapie von Knochenerkrankungen. Steinkopff, Heidelberg. https://doi.org/10.1007/978-3-642-57626-3_7

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  • DOI: https://doi.org/10.1007/978-3-642-57626-3_7

  • Publisher Name: Steinkopff, Heidelberg

  • Print ISBN: 978-3-7985-1266-5

  • Online ISBN: 978-3-642-57626-3

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