Trabecular structure quantified with the MRI-based virtual bone biopsy in postmenopausal women contributes to vertebral deformity burden independent of areal vertebral BMD
Trabecular structure quantified with the MRI-based virtual bone biopsy in postmenopausal women contributes to vertebral deformity burden independent of areal vertebral BMD
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DOI：
10.1359/jbmr.070815
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发表时间：
2008-01-01
影响因子：
6.2
通讯作者：
Wehrli, Felix W.
中科院分区：
文献类型：
--
作者：
Ladinsky, Glenn A.;Vasilic, Branimir;Wehrli, Felix W.
在具有多种椎体畸形的绝经后妇女中，基于mri的桡骨远端拓扑和尺度的结构测量显示，高达30%的椎体畸形与整体椎体骨密度无关。简介：小梁骨结构被认为有助于整体骨强度，而不依赖于DXA测量的椎体骨密度。然而，到目前为止，只有很少的体内证据支持这一假设。材料和方法：绝经后妇女，60-80岁，通过DXA筛选，对髋关节或脊柱t评分在-2.5 +/- 1.0范围内的妇女进行基于mri的虚拟骨活检，以及脚跟宽带超声吸收和胫骨pQCT。对符合入组标准的98名受试者的数据在胫骨远端和桡骨处进行MRI扫描，并计算骨小梁网络的拓扑和尺度。脊柱畸形指数（SDI）通过胸椎和腰椎中线矢状面MR图像的形态测量来评估结构与畸形负担之间的关系。结果：桡骨远端获得的许多结构指标与SDI相关。其中，拓扑表面密度（小梁板的测量）和小梁骨体积分数与SDI呈负相关（p < 0.0001）。两种结构参数的组合占SDI变异的30% (p < 0.0001)，与脊柱骨密度无关，两者无显著相关性。pQCT骨小梁BMD也有弱相关性，而宽带超声吸收则没有。胫骨SDI与结构指标之间无显著相关性。结论：mu MRI在体内获得的桡骨远端结构测量解释了绝经后妇女脊柱畸形总负荷变化的重要部分，与面积骨密度无关。
In postmenopausal women with a wide range of vertebral deformities, MRI-based structural measures of topology and scale at the distal radius are shown to account for as much as 30% of vertebral deformity, independent of integral vertebral BMD.Introduction: Trabecular bone architecture has been postulated to contribute to overall bone strength independent of vertebral BMD measured by DXA. However, there has thus far been only sparse in vivo evidence to support this hypothesis.Materials and Methods: Postmenopausal women, 60-80 yr of age, were screened by DXA, and those with T-scores at either the hip or spine falling within the range of -2.5 +/- 1.0 were studied with the MRI-based virtual bone biopsy, along with heel broadband ultrasound absorption and pQCT of the tibia. The data from 98 subjects meeting the enrollment criteria were subjected to mu MRI at the distal tibia and radius, and measures of topology and scale of the trabecular bone network were computed. A spinal deformity index (SDI) was obtained from morphometric measurements in midline sagittal MR images of the thoracic and lumbar spine to evaluate associations between structure and deformity burden.Results: A number of structural indices obtained at the distal radius were correlated with the SDI. Among these were the topological surface density (a measure of trabecular plates) and trabecular bone volume fraction, which were inversely correlated with SDI (p < 0.0001). Combinations of two structural parameters accounted for up to 30% of the variation in SDI (p < 0.0001) independent of spinal BMD, which was not significantly correlated. pQCT trabecular BMD was also weakly associated, whereas broadband ultrasound absorption was not. No significant association between SDI and structural indices were found at the tibia.Conclusions: Structural measures at the distal radius obtained in vivo by mu MRI explained a significant portion of the variation in total spinal deformity burden in postmenopausal women independent of areal BMD.