Regional analysis of age-related local bone loss in the spine of a healthy population using 3D voxel-based modeling
Regional analysis of age-related local bone loss in the spine of a healthy population using 3D voxel-based modeling
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DOI：
10.1016/j.bone.2017.06.013
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发表时间：
2017-10-01
期刊：
影响因子：
4.1
通讯作者：
Kirschke, Jan S.
中科院分区：
文献类型：
--
作者：
Valentinitsch, Alexander;Trebeschi, Stefano;Kirschke, Jan S.
局部骨质流失的变化可能对单独预测骨质疏松性骨折非常重要，但目前的密度测量技术却忽视了这一点。本研究的目的是利用基于体素的形态测量法评估不同年龄组脊柱正常骨质流失的区域差异。16名年龄在40岁以下（平均年龄26岁）无脊柱病理的患者进行非对比MDCT扫描作为参考队列，其中每个胸腰椎被单独评估。为了进行比较，38例年龄在40岁至40岁之间的患者分为4个队列，每组10例患者，除最年轻的患者外，只有8例患者。对空间归一化的椎体自动检测、分割和非刚性注册所有脊柱。随后，进行统计和t评分制图，以突出与参考队列相比的局部密度差异。计算出的显著影响密度区（ADR）统计图开始突出50岁队列中L5椎体内体积骨矿物质密度（vBMD）分布的局部小变化（ADR: 7.9%）。靠近端板的区域受影响最大。这种效果在60年代的队列中显著增加，骨质流失在112岁到L2岁之间最为突出。在70年代队列中，T10至L5约50%的体素显示vBMD显着降低。总之，ADR和脊柱局部t评分图显示了健康人群中与年龄相关的局部变化，与已知的骨折发生区域和骨折发生率增加相对应。因此，它可能为骨质疏松症的诊断提供一个强有力的工具。(C) 2017年Elsevier Inc.出版。
Local variations in bone loss may be of great importance to individually predict osteoporotic fractures but are neglected by current densitometry techniques. The purpose of this study was to evaluate regional variations of normal bone loss at the spine among different age groups using voxel-based morphometry. Non-contrast MDCT scans of 16 patients under the age of 40 (mean age 26 years) without spinal pathology were identified as a reference cohort, where each thoracolumbar vertebra was assessed individually. For comparison, 38 patients >40 years were grouped by decades in 4 cohorts of 10 patients each, except the youngest, including 8 patients only. All spines were automatically detected, segmented and non-rigidly registered for spatially normalized vertebral bodies. Afterwards, statistical and T-score mapping was performed to highlight local density differences in comparison to the reference cohort. The calculated statistical maps of significantly affected density regions (ADR) started to highlight small local changes of volumetric bone mineral density (vBMD) distribution within the vertebra of L5 (ADR: 7.9%) in the fifties cohort. Regions near the endplates were most affected. The effect dramatically increased in the sixties cohort, where bone loss was most prominent from 112 to L2. In the seventies cohort, around 50% of voxels in T10 to L5 showed significantly decreased vBMD. In conclusion, ADR and local T-score maps of the spine showed age-related local variations in a healthy population, corresponding to known areas of fracture origination and increased fracture incidence. It thus might provide a powerful tool in diagnosis of osteoporosis. (C) 2017 Published by Elsevier Inc.