Compromised bone marrow perfusion in osteoporosis
Compromised bone marrow perfusion in osteoporosis
复制标题
DOI：
10.1359/jbmr.080233
复制
发表时间：
2008-07-01
影响因子：
6.2
通讯作者：
Leung, Ping C.
中科院分区：
文献类型：
--
作者：
Griffith, James F.;Yeung, David K. W.;Leung, Ping C.
骨血流和骨质疏松症之间可能存在联系。在脊柱外，股骨近端是骨质疏松性骨折最常见的部位，也是容易发生缺血性坏死和骨折不愈合的区域。这项关于股骨近端的研究调查了骨密度、骨髓脂肪含量、骨灌注量和肌肉灌注量之间的关系。120名健康女性受试者(平均年龄74岁，年龄范围67-89岁)接受了髋关节DXA检查、质子磁共振波谱检查和右侧股骨近端、髋臼和大腿内收肌的动态增强磁共振成像。骨质疏松症患者的所有骨区(股骨头、股骨颈、股骨干、髋臼)的血流灌注指数(最大增强值、增强斜率)均显著低于骨量减少或骨密度正常的患者。内收肌血流灌注不受骨密度变化的影响。随着股骨近端骨髓灌注量的减少，骨髓脂肪增加(r=0.827)。脂肪含量的增加似乎更多地解释了骨髓灌注量的减少，而不是BMD的减少。对于正常骨密度受试者，股骨头的血流灌注参数是股骨颈或股骨干的三分之一和髋臼的五分之一。与骨质疏松和正常受试者相比，骨质疏松受试者股骨近端的血流灌注量减少。这种血流灌注的减少只影响骨骼，而不影响骨外具有相同血液供应的组织。随着骨灌注量的减少，骨髓脂肪也相应增加。
A link between bone blood flow and osteoporosis may exist. Outside of the spine, the proximal femur is the most common site of osteoporotic fracture and is also an area prone to avascular necrosis and fracture nonunion. This study of the proximal femur investigates the relationship between BMD, bone marrow fat content, bone perfusion, and muscle perfusion. One hundred twenty healthy female subjects (mean age, 74 yr; age range, 67-89 yr) underwent DXA examination of the hip, proton MR spectroscopy, and dynamic contrast-enhanced MR imaging of the right proximal femur, acetabulum, and adductor thigh muscle. In all bone areas examined (femoral head, femoral neck, femoral shaft, acetabulum), perfusion indices (maximum enhancement, enhancement slope) were significantly reduced in subjects with osteoporosis compared with subjects with osteopenia or normal BMD. Adductor muscle perfusion was not affected by change in BMD. As marrow perfusion decreased in the proximal femur, marrow fat increased (r = 0.827). This increase in fat content seemed to account for the decrease in marrow perfusion more than a reduction in BMD. For normal BMD subjects, perfusion parameters in the femoral head were one third of those in the femoral neck or shaft and one fifth of those in the acetabulum. Perfusion throughout the proximal femur is reduced in osteoporotic subjects compared with osteopenic and normal subjects. This reduction in perfusion only affects bone and not those tissues outside of bone with the same blood supply. As bone perfusion decreased, there was a corresponding increase in marrow fat.