Volumetric quantitative computed tomography of the proximal femur: Precision and relation to bone strength
Volumetric quantitative computed tomography of the proximal femur: Precision and relation to bone strength
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DOI：
10.1016/s8756-3282(97)00072-0
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发表时间：
1997-07-01
期刊：
影响因子：
4.1
通讯作者：
Genant, HK
中科院分区：
文献类型：
--
作者：
Lang, TF;Keyak, JH;Genant, HK
我们开发了一种三维计算机断层扫描（CT）和图像分析方法，用于测量自动确定的股骨近端股骨颈和转子亚区的骨小梁和整体骨矿物质密度（BMD）和几何形状。我们测量了密度和几何形状变量与模拟单肢条件和侧摔载荷下体外评估的股骨强度的相关性。虽然BMD单独解释了站立载荷配置的力量变异性的48%-77%，但股骨颈横截面积（minCSA）和股骨颈轴长（FNAL）也独立地对股骨力量做出贡献，并且BMD和几何变量的组合解释了数据中87%-93%的变异性。仅大转子骨小梁BMD可解释87%的强度变异。在一组7名绝经后妇女中评估了该技术的体内再现性，这些妇女接受了重复扫描和重新定位。对于骨小梁BMD，股骨颈和转子亚区的精确度分别为1.1%和0.6%，而相应的积分包络分别为3.3%和1.6%，因此，骨小梁骨密度测量是可重复的，并且与生物力学强度测量高度相关。这些结果支持定量CT评估股骨近端骨质疏松症的进一步探索。(C)Elsevier Science Inc.出版。All rights reserved.
We have developed a three-dimensional computed tomography (CT) scanning and image analysis method for measurement of trabecular and integral bone mineral density (BMD) and geometry in automatically determined femoral-neck and trochanteric subregions of the proximal femur, We measured the correlation of the density and geometry variables to femoral strength assessed in vitro under loading simulating a single-limb condition and a fall to the side. While BMD alone accounted for 48%-77% of the variability in strength for the stance loading configuration, femoral neck cross-sectional area (minCSA) and femoral neck axis length (FNAL) also contributed independently to femoral strength, and a combination of BMD and geometry variables explained 87%-93% of the variance in the data, For the fall loading configuration, trochanteric trabecular BMD alone explained 87% of the variability of strength. The reproducibility in vivo of the technique was assessed in a group of seven postmenopausal women, who underwent repeat scans with repositioning, For trabecular BMD, the precision was 1.1% and 0.6% for the femoral neck and trochanteric subregions, respectively, compared to 3.3% and 1.6% for the corresponding integral envelopes, Thus, trabecular BMD measurements were reproducible and highly correlated to biomechanical strength measurements. These results support further exploration of quantitative CT for assessment of osteoporosis at the proximal femur. (C) 1997 by Elsevier Science Inc. All rights reserved.