In Vivo Assessment of Trabecular Microstructure at the Proximal Femur

股骨近端小梁微观结构的体内评估

• 批准号: 8119114
• 负责人: Roland Krug
• 金额: $ 27.04万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-09-01 至 2013-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8119114
• 关键词: Age; American; Architecture; Bone Density; Brain imaging; Caring; Clinical; Clinical assessments; Cross-Sectional Studies; Discrimination; Disease; Dual-Energy X-Ray Absorptiometry; Early Diagnosis; Elderly; Expenditure; Feasibility Studies; Femur; Fracture; Goals; Health; Hip Fractures; Hip region structure; Hospitals; Image; Imaging Techniques; Individual; Left; Location; Magnetic Resonance Imaging; Measurement; Metals; Monitor; Morbidity - disease rate; Morphologic artifacts; Musculoskeletal; Noise; Nursing Homes; Osteoporosis; Outpatients; Patients; Peripheral; Population; Postmenopause; Process; Public Health; Publications; RF coil; Radial; Recruitment Activity; Research; Resolution; Risk; Services; Signal Transduction; Site; Spinal Fractures; Structure; Study of magnetics; Techniques; Testing; Thick; Three-Dimensional Image; Time; United States; Woman; aged; bone; bone mass; bone strength; imaging modality; improved; in vivo; men; mortality; osteoporosis with pathological fracture; prevent; programs; prototype; public health relevance; response; sample fixation; skeletal; socioeconomics; substantia spongiosa; treatment strategy

DESCRIPTION (provided by applicant): This research will advance our understanding of osteoporosis. Osteoporosis is a disease in which bones become fragile and more likely to break. If not prevented or if left untreated, osteoporosis can progress painlessly until a bone fractures. It is a major public health threat for an estimated 44 million Americans. In particular, osteoporotic fractures of the proximal femur are the most common and often result in high rates of morbidity and mortality. An average of 24 percent of hip fracture patients aged 50 and over die in the year following their fracture. This represents a serious socioeconomic health problem that is expected to worsen as the size of the elderly population increases. Numerous publications have demonstrated that bone mineral density alone cannot entirely differentiate between osteoporotic and healthy subjects and that the structural make-up of trabecular bone provides additional information to assess the risk of fracture. Imaging of the proximal femur has not yet been performed in vivo with high resolution. In MRI, this is mainly due to signal to noise issues and a lack of dedicated imaging coils. With the proposed technique, in vivo 3D-images of the entire proximal femur with sufficient high spatial resolution to visualize the trabecular microstructure will be acquired. Structural parameters of the trabecular bone will be derived from these images. These parameters have been shown to be well suited for predicting hip fracture. Through early detection, the progression and response to therapy can be monitored more sensitively, and the risk of hip fracture effectively ascertained. The proposed study will provide the first assessment of trabecular bone microstructure in the proximal femur. The results of the proposed research may also influence treatment strategies. PUBLIC HEALTH RELEVANCE: This research will advance our understanding of osteoporosis. Osteoporosis is a disease in which bones become fragile and more likely to break. If not prevented or if left untreated, osteoporosis can progress painlessly until a bone breaks. It is a major public health threat for an estimated 44 million Americans. In particular, osteoporotic fractures of the proximal femur are the most common and often result in high rates of morbidity and mortality. An average of 24 percent of hip fracture patients aged 50 and over die in the year following their fracture. This represents a serious socioeconomic health problem that is expected to worsen as the size of the elderly population increases. With the proposed technique, 3-D images of the proximal femur in vivo with sufficient spatial resolution will be acquired for the first time. Structural bone parameters derived from these enhanced images are suited to predict hip fracture. Through early detection, the progression and response to therapy can be monitored more sensitively, and the risk of hip fracture effectively ascertained. The proposed study will provide the first assessment of trabecular bone microstructure in the proximal femur. The results of the proposed research may also influence treatment strategies.

描述（由申请人提供）：本研究将促进我们对骨质疏松症的认识。骨质疏松症是一种骨骼变得脆弱，更容易断裂的疾病。如果不加以预防或不加以治疗，骨质疏松症可以无痛地发展直至骨折。对大约4400万美国人来说，这是一个主要的公共健康威胁。特别是，股骨近端骨质疏松性骨折是最常见的，通常导致高发病率和死亡率。在50岁及以上的髋部骨折患者中，平均有24%的人在骨折后的一年内死亡。这是一个严重的社会经济健康问题，预计随着老年人口规模的增加，这一问题将进一步恶化。许多出版物表明，仅靠骨密度不能完全区分骨质疏松症患者和健康受试者，骨小梁的结构构成为评估骨折风险提供了额外的信息。股骨近端尚未在体内进行高分辨率成像。在MRI中，这主要是由于信号噪声问题和缺乏专用成像线圈。使用该技术，将获得整个股骨近端具有足够高空间分辨率的体内3d图像，以显示小梁微观结构。小梁骨的结构参数将从这些图像中得到。这些参数已被证明非常适合于预测髋部骨折。通过早期发现，可以更敏感地监测病情进展和对治疗的反应，并有效地确定髋部骨折的风险。该研究将首次评估股骨近端骨小梁的微观结构。拟议的研究结果也可能影响治疗策略。公共卫生相关性：这项研究将促进我们对骨质疏松症的理解。骨质疏松症是一种骨骼变得脆弱，更容易断裂的疾病。如果不加以预防或不加以治疗，骨质疏松症可以无痛地发展，直到骨折。对大约4400万美国人来说，这是一个主要的公共健康威胁。特别是，股骨近端骨质疏松性骨折是最常见的，通常导致高发病率和死亡率。在50岁及以上的髋部骨折患者中，平均有24%的人在骨折后的一年内死亡。这是一个严重的社会经济健康问题，预计随着老年人口规模的增加，这一问题将进一步恶化。利用该技术，将首次获得具有足够空间分辨率的股骨近端活体三维图像。从这些增强图像中得到的骨结构参数适合于预测髋部骨折。通过早期发现，可以更敏感地监测病情进展和对治疗的反应，并有效地确定髋部骨折的风险。该研究将首次评估股骨近端骨小梁的微观结构。拟议的研究结果也可能影响治疗策略。