Computed Tomography Image Analysis of the Calcaneus in Male Osteoporosis
Computed Tomography Image Analysis of the Calcaneus in Male Osteoporosis
复制标题
男性骨质疏松症跟骨的计算机断层扫描图像分析
DOI：
10.1007/s198-002-8335-4
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发表时间：
2002
影响因子：
4
通讯作者：
X. Marchandise
中科院分区：
文献类型：
--
作者：
B. Cortet;P. Dubois;N. Boutry;G. Palos;A. Cotten;X. Marchandise
本研究旨在通过计算机断层扫描（CT）评估患有骨质疏松症的男性受试者跟骨的骨微结构特征。对79名受试者进行了评估（45名骨质疏松症受试者和34名年龄匹配的对照受试者）。骨质疏松症根据世界卫生组织分类定义为腰椎或股骨颈。33例受试者（73%）有低能量骨折病史，主要表现为椎骨骨折（24/33）。为每例受试者选择9个轴向切片（宽度为1 mm，间距为2 mm）。使用结构（二值化和灰度化图像，以及灰度化）和分形分析进行骨微结构分析。73例患者还进行了跟骨双能X线吸收法（DXA）骨密度测定。与对照组相比，腰椎、髋部和跟骨的骨矿物质密度（BMD）在骨质疏松患者中均降低（p<0.01）。在25个测量指标中，有14个指标在两组间有显著性差异（P<0.01）。对照组每降低1个标准差，骨折的比值比对于13个结构特征以及跟骨BMD也是显著的。调整跟骨BMD后，以下特征的比值比具有显著性（p<0.05）：谷数，2.8（1.2-6.9）;小梁间隔，3.3（1.3-7.9）;表观骨小梁间距，1.8（1.0-3.1）;松质骨模式因子，2.2（1.1-4.3）;欧拉数，3.0（1.1-8.7）;节点到末端支柱计数，3.3（1.4-7.8）;末端到末端支柱计数，2.9（1.2-6.9）;和分形维数，3.7（1.5-9.7）。DXA测量的跟骨BMD与CT获得的特征之间的相关性很小，表明这两种方法提供了不同的骨状态信息。总之，男性骨质疏松症是一种以骨量减少为特征的疾病，但也是骨组织微结构恶化的疾病，其部分独立于BMD。
The present study aimed to characterize bone microarchitecture assessed by computed tomography (CT) at the calcaneus in male subjects suffering from osteoporosis. Seventy-nine subjects were assessed (45 with osteoporosis and 34 control subjects matched for age). Osteoporosis was defined according to the World Health Organization classification either at the lumbar spine or at the femoral neck. Thirty-three subjects (73%) had a past history of low-energy fracture mainly represented by vertebral fractures (24/33). Nine axial sections (1 mm in width and 2 mm apart) were selected for each subject. Bone microarchitecture analysis was performed using structural (binary and skeletonized images but also skeletonization from gray levels) and fractal analyses. Bone densitometry by dual-energy X-ray absorptiometry (DXA) at the calcaneus was also performed in 73 cases. Bone mineral density (BMD) was decreased in osteoporotic patients compared with controls both at the lumbar spine and hip and also at the calcaneus (p<0.01). Also 14 microarchitectural features among 25 measured were significantly different between the two groups (p<0.01). The odds ratio for fracture per 1 control group standard deviation decrease were also significant for 13 structural features but also for BMD at the calcaneus. The odds ratios after adjustment for BMD at the calcaneus were significant for the following features (p<0.05): number of valleys, 2.8 (1.2–6.9); trabecular partition, 3.3 (1.3–7.9); apparent trabecular spacing, 1.8 (1.0–3.1); trabecular bone pattern factor, 2.2 (1.1–4.3); Euler number, 3.0 (1.1–8.7); node-to-terminus strut count, 3.3 (1.4–7.8); terminus-to-terminus strut count, 2.9 (1.2–6.9); and fractal dimension, 3.7 (1.5–9.7). Few and weak correlations were found between BMD at the calcaneus measured with DXA and features obtained from CT, suggesting that these two methods give different information about bone status. In conclusion, male osteoporosis is a disease characterized by decreased bone mass but also by microarchitectural deterioration of bone tissue which is partly independent of BMD.