Characterization of Heterotopic Ossification Using Radiographic Imaging: Evidence for a Paradigm Shift.
Characterization of Heterotopic Ossification Using Radiographic Imaging: Evidence for a Paradigm Shift.
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DOI：
10.1371/journal.pone.0141432
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发表时间：
2015
期刊：
影响因子：
3.7
通讯作者：
Levi B
中科院分区：
文献类型：
--
作者：
Brownley RC;Agarwal S;Loder S;Eboda O;Li J;Peterson J;Hwang C;Breuler C;Kaartinen V;Zhou B;Mishina Y;Levi B
异位骨化（HO）是发生在创伤、烧伤和遗传性骨形态发生蛋白（BMP）受体突变患者中的骨外骨生长。HO的临床和实验室评价依赖于放射成像来识别和表征这些病变。在这里，我们表明，尽管其不足之处，平片X线摄影和单一模态microCT继续作为一个主要的方法HO成像在近30%的已发表的体内文献。此外，我们证明，详细的microCT分析上级平片和单一模态microCT X线摄影，特别是在评价通过三种代表性模型形成的HO时，因为其能够1）定义生长的骨外骨与正常解剖骨之间的结构关系，2）根据占位病变的体积提供准确的定量和生长速率，从而促进治疗干预的评估，3）在较早的时间识别HO以允许早期干预的评估，以及4）表征骨生理学的度量，包括孔隙率、组织矿物质密度以及皮质和小梁体积。使用microCT检查我们的创伤模型，根据解剖位置和与周围正常骨结构的关系，显示了两个独立的HO区域。此外，microCT允许评价HO生长速率以表征HO进展。综上所述，这些数据表明，需要一个范式转变，在评价HO对microCT作为一个标准的成像工具。
Heterotopic ossification (HO) is the growth of extra-skeletal bone which occurs following trauma, burns, and in patients with genetic bone morphogenetic protein (BMP) receptor mutations. The clinical and laboratory evaluation of HO is dependent on radiographic imaging to identify and characterize these lesions. Here we show that despite its inadequacies, plain film radiography and single modality microCT continue to serve as a primary method of HO imaging in nearly 30% of published in vivo literature. Furthermore, we demonstrate that detailed microCT analysis is superior to plain film and single modality microCT radiography specifically in the evaluation of HO formed through three representative models due to its ability to 1) define structural relationships between growing extra-skeletal bone and normal, anatomic bone, 2) provide accurate quantification and growth rate based on volume of the space-occupying lesion, thereby facilitating assessments of therapeutic intervention, 3) identify HO at earlier times allowing for evaluation of early intervention, and 4) characterization of metrics of bone physiology including porosity, tissue mineral density, and cortical and trabecular volume. Examination of our trauma model using microCT demonstrated two separate areas of HO based on anatomic location and relationship with surrounding, normal bone structures. Additionally, microCT allows HO growth rate to be evaluated to characterize HO progression. Taken together, these data demonstrate the need for a paradigm shift in the evaluation of HO towards microCT as a standard tool for imaging.