Barger-Lux M Janet, Recker Robert R
Osteoporosis Research Center, Creighton University School of Medicine, 601 North 30th Street, Omaha, NE 68131, USA.
Top Magn Reson Imaging. 2002 Oct;13(5):297-305. doi: 10.1097/00002142-200210000-00002.
The bone fragility of osteoporosis is not fully explained by a deficit in bone mass. Histomorphometric examination of transilial bone biopsies has identified microstructural defects that-in light of what is known about the mechanical properties of structural materials-further compromise bone strength. Histomorphometric measures describe the biopsy specimen, the configuration of its trabeculae in space, and the extent to which its trabecular lattice is intact. In postmenopausal women with established osteoporosis, a deficit of both cortical and cancellous bone is typical, i.e., both cortical thickness and cancellous bone volume tend to be substantially reduced. Much of the cancellous bone deficit can be attributed to loss of entire trabecular elements rather than to generalized thinning of trabeculae. Direct measures of trabecular connectivity confirm this impression: women with established osteoporosis have fewer trabecular nodes and more termini than healthy women, even at the same cancellous bone volume. Evidence for accumulated microdamage in transilial biopsies is circumstantial, and the phenomenon itself may well be localized to fracture sites. Histomorphometric data from transilial biopsies comprise a large body of information about the structural and functional character of osteoporosis and provide valuable information about the effects of new treatments on bone microstructure.
骨质疏松症的骨脆性不能完全用骨量不足来解释。对髂骨活检进行组织形态计量学检查发现了微观结构缺陷，根据已知的结构材料力学性能，这些缺陷会进一步损害骨强度。组织形态计量学测量描述了活检标本、其小梁在空间中的构型以及其小梁网络的完整程度。在已确诊骨质疏松症的绝经后女性中，皮质骨和松质骨的缺乏是典型的，即皮质厚度和松质骨体积往往会大幅减少。松质骨的大量缺乏可归因于整个小梁单元的丢失，而不是小梁的普遍变薄。对小梁连接性的直接测量证实了这一印象：即使在相同的松质骨体积下，已确诊骨质疏松症的女性比健康女性的小梁节点更少，末端更多。髂骨活检中累积微损伤的证据是间接的，而且这种现象本身很可能局限于骨折部位。髂骨活检的组织形态计量学数据包含了大量关于骨质疏松症结构和功能特征的信息，并提供了关于新治疗方法对骨微观结构影响的有价值信息。
