Characterization of the integrity of three-dimensional trabecular bone microstructure by connectivity and shape analysis using high-resolution magnetic resonance imaging in vivo.

Bone mineral density and bone structure are the main determinants of bone strength in osteoporosis. In this study we used high-resolution magnetic resonance imaging to visualize the bone microstructure in the finger phalanges in vivo and to assess the topological three-dimensional connectivity of the trabecular network and the shape of the trabeculae as measures of bone quality. We visualized the phalanges of young and elderly healthy volunteers in vivo with a spatial resolution of 152 microm x 152 microm x 280 microm. Image processing software to quantify three measures of connectedness was developed and tested: connectivity, global connectivity density, and local connectivity density. Global three-dimensional connectivity ranged from 904 to 1,607 connections. Global connectivity density ranged from 2.9 to 4.7 connections per mm with large intersubject differences. We found a decrease of local connectivity density with growing distance from the joint ranging from 5.1 to 0.2 connections per mm. These preliminary results represent a quantitative description of the well-known rarefication of the trabecular network when moving from epiphysis to the diaphysis. Three-dimensional visualization showed a dense network consisting mostly of rod-like trabeculae at the epiphysis changing to a less dense network of a few plate-like structures near the medullary canal. An algorithm for the quantitative classification of trabecular architecture with regard to plate or rod-like shape was tested for feasibility. We conclude that in vivo assessment of three-dimensional properties of the trabecular network is possible in human phalanges. Determination of connectivity and shape will allow quantification of structural aspects of osteoporotic changes and may improve assessment of fracture risk.