In vivo assessment of trabecular bone microarchitecture by high-resolution peripheral quantitative computed tomography
In vivo assessment of trabecular bone microarchitecture by high-resolution peripheral quantitative computed tomography
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DOI：
10.1210/jc.2005-1258
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发表时间：
2005-12-01
影响因子：
5.8
通讯作者：
Delmas, PD
中科院分区：
文献类型：
--
作者：
Boutroy, S;Bouxsein, ML;Delmas, PD
背景：对骨小梁微结构的评估可能会增强骨折风险的预测，并改善治疗反应的监测。一种新的高分辨率外周定量计算机断层扫描(HR-pQCT)系统可以在体内评估体素大小为82微米(3)的桡骨和胫骨远端的骨小梁结构和体积骨密度(BMD)。目的和患者：我们通过对15名健康志愿者每人测量3次来确定该设备的短期重复性。我们比较了108名健康绝经前妇女、113名绝经后骨质疏松症妇女和35名绝经后骨质疏松症妇女的HR-pQCT测量结果。此外，我们比较了绝经后骨质疏松症妇女(n=35)和没有骨折病史(n=78)的女性。设计和地点：我们在一家私人临床研究中心进行了一项横断面研究。干预和主要观察指标：我们进行了桡骨和胫骨的HR-pQCT测量。采用双能X线骨密度仪测量绝经后妇女股骨颈和脊柱骨密度。结果：HR-pQCT测量骨小梁、骨小梁和皮质骨密度的精确度为0.7%~1.5%，骨小梁结构的测量精度为2.5%~4.4%。绝经后妇女的骨小梁密度、骨小梁数目和皮质厚度均低于绝经前妇女(P<；0.001)。在这两个部位，骨质疏松女性的密度、皮质厚度和骨小梁间距均低于骨质疏松症女性(P<；0.01)。此外，尽管脊柱和髋部的骨密度相似，但骨折的骨质疏松女性与未骨折的骨质疏松女性相比，其骨小梁密度更低，在桡骨的分布更不均匀(P<；0.02)。结论：从重复性和检测年龄和疾病相关变化的能力来看，HR-pQCT似乎有希望评估周围部位的骨密度和微结构。
Context: Assessment of trabecular microarchitecture may enhance the prediction of fracture risk and improve monitoring of treatment response. A new high-resolution peripheral quantitative computed tomography (HR-pQCT) system permits in vivo assessment of trabecular architecture and volumetric bone mineral density (BMD) at the distal radius and tibia with a voxel size of 82 mu m(3).Objective and Patients: We determined the short-term reproducibility of this device by measuring 15 healthy volunteers three times each. We compared HR-pQCT measurements in 108 healthy premenopausal, 113 postmenopausal osteopenic, and 35 postmenopausal osteoporotic women. Furthermore, we compared values in postmenopausal osteopenic women with (n = 35) and without previous fracture history (n = 78).Design and Setting: We conducted a cross-sectional study in a private clinical research center.Intervention and Main Outcome Measure: We took HR-pQCT measurements of the radius and tibia. Femoral neck and spine BMD were measured in postmenopausal women by dual-energy x-ray absorptiometry.Results: Precision of HR-pQCT measurements was 0.7-1.5% for total, trabecular, and cortical densities and 2.5-4.4% for trabecular architecture. Postmenopausal women had lower density, trabecular number, and cortical thickness than premenopausal women (P < 0.001) at both radius and tibia. Osteoporotic women had lower density, cortical thickness, and increased trabecular separation than osteopenic women (P < 0.01) at both sites. Furthermore, although spine and hip BMD were similar, fractured osteopenic women had lower trabecular density and more heterogeneous trabecular distribution (P < 0.02) at the radius compared with unfractured osteopenic women.Conclusion: HR-pQCT appears promising to assess bone density and microarchitecture at peripheral sites in terms of reproducibility and ability to detect age- and disease-related changes.