Relationship between structural parameters, bone mineral density and fracture load in lumbar vertebrae, based on high-resolution computed tomography, quantitative computed tomography and compression tests
Relationship between structural parameters, bone mineral density and fracture load in lumbar vertebrae, based on high-resolution computed tomography, quantitative computed tomography and compression tests
复制标题
DOI：
10.1007/s001980050168
复制
发表时间：
1999-01-01
影响因子：
4
通讯作者：
Werner, HJ
中科院分区：
文献类型：
--
作者：
Haidekker, MA;Andresen, R;Werner, HJ
介绍了评估骨质疏松症个体骨折风险的不同无创技术，并分析了椎体高分辨率计算机断层扫描（HR-CT）图像的结构特性、骨密度（BMD）与骨折负荷之间的关系。对6例24例不同程度脱矿的未骨折腰椎标本，采用定量CT测定骨小梁和皮质骨密度。侧位x线图像显示整个脊柱骨折的数量。基于HR-CT图像对海绵骨和皮质骨进行结构分析。在海绵中，分形维数作为阈值的函数计算。在皮质壳中，在不同的阈值下确定了低骨密度簇的最大数量。CT测量后，切除椎骨并压缩至骨折。根据海绵体骨密度及骨折次数，3例为重度骨质疏松；其余3例表现为骨质减少。非骨质疏松患者（2602 ~ 5802 N）的平均骨折载荷为3533 N，骨质疏松患者（1311 ~ 2490 N）的平均骨折载荷为1725 N。测定参数如下：非骨质疏松组平均骨密度为115.2 mg/ml (101.8 ~ 135.3 mg/ml)，骨质疏松组平均骨密度为46.2 mg/ml (34.8 ~ 57.6 mg/ml)；平均皮质骨密度：非骨质疏松患者为285.1 mg/ml (216.4 ~ 361.9 mg/ml)，骨质疏松患者为136.1 mg/ml (142.5 ~ 215.2 mg/ml)；海绵组织：非骨质疏松患者平均0.5（范围0.32-0.75），骨质疏松患者平均1.05（范围0.87-1.24）；皮质结构：非骨质疏松症患者平均81（范围55-104），骨质疏松症患者平均136（范围102-159）。单一参数（骨密度和结构）及其加权和均与骨折载荷相关，相关系数为r(sBMD) = 0.82（海绵状骨密度），r(cBMD) = 0.82（皮质骨密度），r(sStr) = -0.75（海绵状结构），r(cStr) = -0.86（皮质结构）。皮质和海绵体骨密度加权和r(BMD) = 0.86，皮质和海绵体骨密度加权和r(Str) = -0.86。所有四个参数的加权组合与断裂载荷相关，r(4) = 0.89，所有相关性均具有统计学意义(p
Different noninvasive techniques for the assessment of the individual fracture risk in osteoporosis are introduced, and the relation between structural properties of high-resolution computed tomography (HR-CT) images of vertebral bodies, their bone mineral density (BMD) and the fracture load is analyzed. In 24 unfractured lumbar vertebrae with different degrees of demineralization from six specimens, the trabecular and cortical BMD was determined using quantitative CT. A lateral X-ray image revealed the number of fractures in the entire spine. A structural analysis of spongy and cortical bone was performed based on the HR-CT images. In the spongiosa, the fractal dimension was calculated as a function of the threshold value. In the cortical shell, the maximum number of clusters of low BMD was determined at varying threshold values. After the CT measurements the vertebrae were excised and compressed until fractured. On the basis of the spongiosa BMD and the number of fractures, 3 cases were found to be severely osteoporotic; the other 3 cases showed osteopenia. The average fracture loads were determined as 3533 N for the non-osteoporotic cases (range 2602-5802 N) and 1725 N for the osteoporotic cases (range 1311-2490 N). The parameters were determined as follows: average spongiosa BMD 115.2 mg/ml (101.8-135.3 mg/ml) for the nonosteoporotic cases, 46.2 mg/ml (34.8-57.6 mg/ml) for the osteoporotic cases; average cortical BMD 285.1 mg/ml (216.4-361.9 mg/ml) for the non-osteoporotic cases, 136.1 mg/ml (142.5-215.2 mg/ml) for the osteoporotic cases; spongiosa structure: average 0.5 (range 0.32-0.75) for the non-osteoporotic cases, average 1.05 (range 0.87-1.24) for the osteoporotic cases; cortical structure: average 81 (range 55-104) for the non-osteoporotic cases), average 136 (range 102-159) for the osteoporotic cases. Single parameters (BMD and structure) and weighted sums of these parameters were correlated with the fracture load, resulting in correlation coefficients of r(sBMD) = 0.82 (spongiosa BMD), r(cBMD) = 0.82 (cortical BMD), r(sStr) = -0.75 (spongiosa structure) and r(cStr) = -0.86 (cortical structure). The weighted sum of cortical and spongiosa BMD resulted in r(BMD) = 0.86, of cortical and spongiosa structure in r(Str) = -0.86. A weighted combination of all four parameters correlates with the fracture load at r(4) = 0.89, all correlations being statistically significant (p