Assessment of vertebral wedge strength using cancellous textural properties derived from digital tomosynthesis and density properties from dual energy X-ray absorptiometry and high resolution computed tomography.
Assessment of vertebral wedge strength using cancellous textural properties derived from digital tomosynthesis and density properties from dual energy X-ray absorptiometry and high resolution computed tomography.
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使用来自数字断层合成的松质纹理特性和来自双能 X 射线吸收测量法和高分辨率计算机断层扫描的密度特性来评估椎体楔强度。
DOI：
10.1016/j.jbiomech.2018.08.019
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发表时间：
2018
影响因子：
2.4
通讯作者：
Flynn,MichaelJ
中科院分区：
文献类型：
--
作者：
Yeni,YenerN;Kim,Woong;Oravec,Daniel;Nixon,Mary;Divine,GeorgeW;Flynn,MichaelJ
本研究的目的是检查数字断层合成（OCT）衍生松质骨纹理测量在模拟楔形骨折条件下预测椎体强度的潜力。使用了来自5名男性和5名女性尸体供体的40个椎体（T6、T8、T11和L3节段）。采用双能X线吸收法（DXA）和高分辨率计算机断层扫描（HRCT）扫描标本，以获得骨矿物质密度（BMD）和含量（BMC）的测量值，并进行骨密度测量以获得骨纹理。使用定制的加载装置，设计用于输送不均匀位移，导致楔形变形，类似于临床观察到的楔形变形，将样本加载至断裂，并记录其断裂强度。混合模型回归用于确定楔强度和骨密度衍生的纹理变量之间的关联，单独和存在BMD或BMC信息。由分形、空隙度和平均截距长度变量导出的分形、空隙度和平均截距长度变量与楔强度相关，并分别解释了高达53%的变异性。从BMC和BMD独立的楔强度的多元回归模型中，得到的纹理变量，特别是分形维数和空隙度。扫描方向横向于脊柱轴和前后位视图的模型具有最高的解释能力（R2adj= 0.91），扫描方向平行于脊柱轴和侧视图提供了一种替代方案（R2adj= 0.88）。总之，BMD可用于检查与椎体楔形强度相关的松质骨质地，并可能补充BMD评估椎体骨折风险。
The purpose of this study was to examine the potential of digital tomosynthesis (DTS) derived cancellous bone textural measures to predict vertebral strength under conditions simulating a wedge fracture. 40 vertebral bodies (T6, T8, T11, and L3 levels) from 5 male and 5 female cadaveric donors were utilized. The specimens were scanned using dual energy X-ray absorptiometry (DXA) and high resolution computed tomography (HRCT) to obtain measures of bone mineral density (BMD) and content (BMC), and DTS to obtain measures of bone texture. Using a custom loading apparatus designed to deliver a nonuniform displacement resulting in a wedge deformity similar to those observed clinically, the specimens were loaded to fracture and their fracture strength was recorded. Mixed model regressions were used to determine the associations between wedge strength and DTS derived textural variables, alone and in the presence of BMD or BMC information. DTS derived fractal, lacunarity and mean intercept length variables correlated with wedge strength, and individually explained up to 53% variability. DTS derived textural variables, notably fractal dimension and lacunarity, contributed to multiple regression models of wedge strength independently from BMC and BMD. The model from a scan orientation transverse to the spine axis and in the anterior-posterior view resulted in highest explanatory capability (R2adj= 0.91), with a scan orientation parallel to the spine axis and in the lateral view offering an alternative (R2adj= 0.88). In conclusion, DTS can be used to examine cancellous texture relevant to vertebral wedge strength, and potentially complement BMD in assessment of vertebral fracture risk.