Advances in imaging approaches to fracture risk evaluation.
Advances in imaging approaches to fracture risk evaluation.
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DOI：
10.1016/j.trsl.2016.09.006
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发表时间：
2017-03
期刊：
影响因子：
--
通讯作者：
Does MD
中科院分区：
文献类型：
--
作者：
Manhard MK;Nyman JS;Does MD
脆性骨折是一个日益严重的问题，目前诊断骨质疏松症的方法并不总是识别需要治疗以预防骨折的个体，并且可能错误识别那些没有风险的个体。传统上，骨折风险评估使用双能X线吸收法，它提供了面积骨矿物质密度（BMD）的测量，在容易骨折的网站。影像学的最新进展表明，增加新的信息，可以提高骨折风险的预测在临床上的承诺。如本文所述，定量计算机断层扫描（QCT）预测髋关节和椎体强度的进展;高分辨率外周QCT（HR-pQCT）和微磁共振成像（μMRI）评估骨小梁的微结构;定量超声（QUS）测量皮质骨的模量或组织刚度;定量超短回波时间MRI方法定量皮质骨中结合水和孔隙水的浓度，其反映了骨的各种力学性质。这些技术中的每一种都提供了骨骼的独特特征，并且可以通过帮助指导治疗决策来改善骨折风险诊断并降低骨折的患病率。
Fragility fractures are a growing problem worldwide, and current methods for diagnosing osteoporosis do not always identify individuals who require treatment to prevent a fracture and may misidentify those not a risk. Traditionally, fracture risk is assessed using dual-energy X-ray absorptiometry, which provides measurements of areal bone mineral density (BMD) at sites prone to fracture. Recent advances in imaging show promise in adding new information that could improve the prediction of fracture risk in the clinic. As reviewed herein, advances in quantitative computed tomography (QCT) predict hip and vertebral body strength; high resolution HR-peripheral QCT (HR-pQCT) and micro-magnetic resonance imaging (μMRI) assess the micro-architecture of trabecular bone; quantitative ultrasound (QUS) measures the modulus or tissue stiffness of cortical bone; and quantitative ultra-short echo time MRI methods quantify the concentrations of bound water and pore water in cortical bone, which reflect a variety of mechanical properties of bone. Each of these technologies provides unique characteristics of bone and may improve fracture risk diagnoses and reduce prevalence of fractures by helping to guide treatment decisions.