DEXA Flashcards

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1
Q

what does DEXA stand for?

A
  • Dual energy X-ray absorptiometry
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2
Q

what is osteoporosis

A
  • a health condition that weakens the bones- more susceptible to fractures
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3
Q

what is DEXA

A
  • bone is isolated from soft tissue attenuation by scanning with 2 different x-ray energies
  • data analysis includes a t-score and a Z- score
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4
Q

t-scores in DEXA

A

indication number of the number of SD between the measurement and standard data

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5
Q

Z-score DEXA

A
  • compares individual measurement to a data mean for those similar in age
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6
Q

how does DEXA work?

A
  • x-ray photons of 2 different energies from 2 different sources in an alternating fashion
  • pencil beam and fan beam technology require the linear displacement of the detector which moves backward and forward under the patient’s body C-arm.
  • PB uses small, angled x-ray beams
  • FB generators use a wider beam that reduces scan times, but increases patient dose
  • the difference in attenuation of the x-rays generates 2-D measurements of bone mineral content
  • a low-resolution image is built up which is measured for bone density changes
  • the signal degree is related to the amount of bone mass present
  • the greater the bone mineral density, the smaller the signal picked up by photon counter
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7
Q

Dual energy- 2 energy beams

A

pencil beam

fan beam

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8
Q

limitations and issues with DEXA

A
  • Object to image receptor distance affects size distortion - algorithms are based on average-sized adults, therefore those above and below average can create interpretation difficulties
  • very low resolution
  • Shows what is wrong, but not the reason why
  • values are only based on average caucasian women
  • 2D images lack volumetric data and evaluation
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9
Q

advantages of DEXA

A
  • has a small radiation dose
  • stable calibration
  • sensitive and accurate in the measurement of subtle changes in BMD
  • can predict the risk of future fractures
  • inexpensive
  • non-invasive
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10
Q

DEXA technique

A
  • a region of interest is drawn around the bone
  • graph is plotted (age on the x-axis), (BMD on y-axis)
  • graph plots the area the patient lies in, in relation to age and BMD (normal, osteopenic, osteoporotic)
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11
Q

concerns in regards to DEXA

A

Magnification

radiation dose

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12
Q

DEXA magnification

A
  • occurs especially in FB scanners
  • object to image receptor distance can affect size distortion on the image
  • since the algorithms are based on average-sized adults, larger adults and small paeds create interpretation difficulties
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13
Q

DEXA radiation dose

A
  • relatively low dose to accurately measure BMD - microsieverts
  • overall lifetime risks are the same as smoking 1/10th of a cigarette
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14
Q

things to consider

A
Ethnicity
gender
paediatric estimations 
clinical history
positioning 
artefacts
anatomical variance e.g. L6
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15
Q

which patients are likely to suffer from loss of Bone Density (adolescents)

A

those with:

  • chronic illness
  • poor diet
  • injuries/illnesses causing mobilisation
  • cancers
  • genetic or hormonal disorders
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16
Q

which patients are likely to suffer from loss of Bone Density (adults)

A

those with

  • chronic illness
  • steroid/corticosteroid use
  • hormonal imbalance
  • poor diet/eating disorder
  • smoking and drinking
17
Q

osteoporosis is

A

a defined vakue of loss of bone density

18
Q

osteopenia

A

a decreased bone density

19
Q

disadvantages of data when applied to patient managemet

A
  • data aqcusition is based on caucasian post-menopausal women (50+) - therefore reliability decreases due to:
Ethnicity
gender
paediatric estimations 
clinical history
positioning 
artefacts
anatomical variance e.g. L6
20
Q

difference between pencil beam and fan beam

A

PB uses small angled x-ray beams and a single detector that move moves across the patient in a linear direction. scans take longer, but dose is lower

FB generators use a wider beam and has multiple detectors that reduces scan times but increases radiation to patient