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      Detecção de calcificação de aorta abdominal por densitometria Translated title: Detection of abdominal aortic calcification by densitometry

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          Abstract

          OBJETIVO: Analisar a acurácia da detecção de calcificação da aorta abdominal por meio de densitometria em comparação com a radiografia lateral de coluna. MATERIAIS E MÉTODOS: Casuística de 80 indivíduos, sendo 50 com diagnóstico de calcificação de aorta abdominal e 30 sem calcificação. Densitometria realizada uma única vez em cada participante, com o paciente em decúbito lateral direito. RESULTADOS: Em relação à idade e ao índice de massa corporal tivemos grupos semelhantes, com idade média de 74,56 ± 10,55 anos e 68,40 ± 10,80 anos e índice de massa corporal de 28,94 ± 6,06 kg/m² e 26,84 ± 4,11 kg/m² nos grupos com calcificação de aorta abdominal e sem calcificação de aorta abdominal, respectivamente. A comparação estatística da densitometria com a radiografia mostra que são semelhantes na detecção da calcificação de aorta abdominal, com valores de 100% na especificidade e valor preditivo positivo; sensibilidade de 94%, valor preditivo negativo de 90,9% e acurácia de 96,3%. Equivalência qualitativa no diagnóstico foi demonstrada pelo índice de correlação de kappa de 0,922. CONCLUSÃO: Os resultados da radiografia e da densitometria são estatisticamente equivalentes, o que permite sugerir a investigação de calcificação de aorta abdominal pela densitometria para a detecção de calcificação da aorta abdominal.

          Translated abstract

          OBJECTIVE: To evaluate the accuracy in the detection of abdominal aortic calcification by densitometry as compared with lateral spine radiography. MATERIALS AND METHODS: Study comprising 80 individuals, 50 of them with abdominal aortic calcification and 30 without calcification. Densitometry was performed once for each participant, with the patient in right lateral decubitus position. RESULTS: Both groups were similar in terms of age range and body mass index - mean age of 74.56 ± 10.55 years and 68.40 ± 10.80 years and mean body mass index of 28.94 ± 6.06 kg/m², and 26.84 ± 4.11 kg/m², respectively for the individuals with abdominal aortic calcification and for the individuals without calcification. A statistical comparison between densitometry and radiography demonstrates similar performances of the two methods in the detection of abdominal aortic calcification, with 100% specificity and positive predictive value, 94% sensitivity, 90.9% negative predictive value, and 96.3% accuracy. Qualitative equivalence in diagnosis was demonstrated by kappa correlation index of 0.922. CONCLUSION: The results obtained by radiography and densitometry were statistically equivalent, which endorses the indication of densitometry for investigating abdominal aortic calcification.

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          Most cited references24

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          Assessment of fracture risk and its application to screening for posmenopausal osteoporosis

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            Effective dose values in bone mineral measurements by photon absorptiometry and computed tomography.

            W Kalender (1992)
            A high degree of uncertainty and irritation predominates in the assessment and comparison of radiation dose values resulting from measurements of bone mineral density of the lumbar spine by photon absorptiometry and X-ray computed tomography. The skin dose values which are usually given in the literature are of limited relevance because the size of the irradiated volumes, the relative sensitivity of the affected organs and the radiation energies are not taken into account. The concept of effective dose, sometimes called whole-body equivalent dose, has to be applied. A detailed analysis results in an effective dose value of about 1 microSv for absorptiometry and about 30 microSv for computed tomography when low kV and mAs values are used. Lateral localizer radiographs, which are necessary for slice selection in CT, mean an additional dose of 30 microSv. Lateral X-ray films of the spine which are frequently taken in combination with absorptiometry result in a dose of 700 microSv or more. The concept of effective dose, the basic data and assumptions used in its assessment and a comparison with other dose burdens (for example the natural background radiation, of typically 2400 microSv per year) are discussed in detail.
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              Comparative assessment of dual-photon absorptiometry and dual-energy radiography.

              Dual-energy bone densitometry can be performed with two types of scanners. The traditional dual-photon absorptiometry (DPA) machines use an isotope source, whereas the newly introduced dual-energy radiography (DER) devices use an incorporated x-ray tube. The authors evaluated the performance of DPA and DER devices at their institution. The short-term precision error in vivo was 1.2% for femoral neck measurements with DER. Long-term precision error in vitro was reduced from 1.30% (DPA) to 0.44% (DER). The scanning time for both spine and hip measurements was reduced from 20-40 minutes to 6-7 minutes. Intraosseous fat sensitivity remained the same, at a level of 12 mg/cm2 apparent decrease of bone mineral density (BMD) per 10% fat by volume change, and for both devices there was no shift in BMD when phantom thickness was increased by 1.5 inches. The correlation of DPA and DER was high: r = .98 for the spine and r = .95 for the femoral neck. Correlation of DPA versus quantitative computed tomography (CT) (r = .83) and DER versus quantitative CT (r = .85) was good. The advent of DER represents a significant advance for the field of bone densitometry.
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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Journal
                rb
                Radiologia Brasileira
                Radiol Bras
                Colégio Brasileiro de Radiologia e Diagnóstico por Imagem (São Paulo )
                1678-7099
                February 2013
                : 46
                : 1
                : 35-38
                Affiliations
                [1 ] Universidade Católica de Brasília Brazil
                [2 ] Fundação Cardiovascular São Francisco de Assis Brazil
                [3 ] Universidade Federal de Minas Gerais Brazil
                Article
                S0100-39842013000100011
                10.1590/S0100-39842013000100011
                bf36d0d7-4dfb-4f26-a15d-292ead67d3d6

                http://creativecommons.org/licenses/by/4.0/

                History
                Product

                SciELO Brazil

                Self URI (journal page): http://www.scielo.br/scielo.php?script=sci_serial&pid=0100-3984&lng=en
                Categories
                RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

                Radiology & Imaging
                Atherosclerosis,Abdominal aorta,Densitometry,Aterosclerose,Aorta abdominal,Densitometria

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