Messent E A, Buckland-Wright J C, Blake G M
Department of Applied Clinical Anatomy, King's College London, School of Biomedical Sciences, Guy's Hospital Campus, London, UK.
Calcif Tissue Int. 2005 Jun;76(6):419-25. doi: 10.1007/s00223-004-0160-7. Epub 2005 Apr 21.
The purpose of this study was to determine whether fractal analysis (FSA) of macroradiographs or bone mineral density (BMD) is more sensitive in detecting disease-related cancellous bone alterations in knee osteoarthritis (OA). Differences in BMD between 11 OA (6 females) and 11 non-OA reference (7 females) tibiae were compared with differences in trabecular organization measured by computerized method of fractal signature analysis (FSA) of digitized macroradiographs (x3.5 to x5). OA knees had anatomic and radiographic evidence of medial compartment disease. FSA measured cancellous bone organization at 4 regions of interest (ROI): medial and lateral subchondral (Sc) and subarticular (Sa) sites, dual X-ray absorptiometry (DXA) measured BMD at the same ROIs. Compared to non-OA, OA tibiae had significant increased (P < 0.05) in FSA of vertical trabeculae in the medial Sa region (trabecular size range: 0.42-0.54; 0.90-1.98 mm) and significant decrease (P < 0.05) in FSA for some horizontal trabeculae in the Sc region (trabecular size range: medial side 0.12-0.18 mm; lateral side 0.12-0.24 mm). Compared to non-OA, BMD of OA tibiae was not significantly different at any ROI. BMD was not sensitive to changes in trabecular organization detected by FSA. The increase in FSA of vertical trabeculae in the medial Sa region was consistent with trabecular fenestration and thinning, which may have been detected as decreased BMD in a larger sample. For studies involving small sample sizes, quantifying changes in trabecular organization is more sensitive than BMD for detecting bone alterations in knee OA.
本研究的目的是确定在检测膝关节骨关节炎（OA）中与疾病相关的松质骨改变方面，大尺寸X线片的分形分析（FSA）或骨密度（BMD）哪一个更敏感。比较了11例OA患者（6例女性）和11例非OA对照者（7例女性）胫骨的BMD差异，以及通过数字化大尺寸X线片（放大3.5至5倍）的分形特征分析（FSA）计算机化方法测量的小梁结构差异。OA膝关节有内侧间室疾病的解剖学和影像学证据。FSA在4个感兴趣区域（ROI）测量松质骨结构：内侧和外侧软骨下（Sc）以及关节下（Sa）部位，双能X线吸收法（DXA）在相同ROI测量BMD。与非OA相比，OA胫骨在内侧Sa区域垂直小梁的FSA显著增加（P < 0.05）（小梁尺寸范围：0.42 - 0.54；0.90 - 1.98 mm），而在Sc区域一些水平小梁的FSA显著降低（P < 0.05）（小梁尺寸范围：内侧0.12 - 0.18 mm；外侧0.12 - 0.24 mm）。与非OA相比，OA胫骨在任何ROI的BMD均无显著差异。BMD对FSA检测到的小梁结构变化不敏感。内侧Sa区域垂直小梁FSA的增加与小梁开窗和变薄一致，在更大样本中这可能被检测为BMD降低。对于涉及小样本量的研究，量化小梁结构变化在检测膝关节OA的骨改变方面比BMD更敏感。
