Mueller D, Link T M, Monetti R, Bauer J, Boehm H, Seifert-Klauss V, Rummeny E J, Morfill G E, Raeth C
Department of Radiology, Technische Universitaet Muenchen, Klinikum rechts der Isar, Ismaninger Str. 22, 81675, Munich, Germany.
Osteoporos Int. 2006 Oct;17(10):1483-93. doi: 10.1007/s00198-006-0130-1. Epub 2006 Jul 18.
The purpose of this study was to obtain different structure measures as the three-dimensional (3D)-based scaling index method (SIM) and standard two-dimensional (2D) bone histomorphometric parameters from high-resolution (HR) magnetic resonance (MR) images of the distal radius and to compare these parameters with bone mineral density (BMD) in their diagnostic performance to differentiate postmenopausal patients with and without vertebral fractures.
Axial HR-MR images of the distal radius were obtained at 1.5 T in 40 postmenopausal women (17 with osteoporotic spine fractures and 23 controls). Trabecular microarchitecture analysis was performed using the new structure measure mP(alpha), derived from the SIM, as well as standard morphological 2D parameters. BMD of the spine was obtained using quantitative computed tomography (QCT). Receiver operating characteristic (ROC) analyses were used to determine diagnostic performance in differentiating both groups. Results were validated by bootstrapping techniques.
Significant differences between both patient groups were obtained using mP(alpha), 2D parameters, and spine BMD (p<0.05). In comparison with the 2D texture parameters [area under the curve (AUC) up to 0.67], diagnostic performance was significantly higher for mP(alpha)(AUC=0.85; p<0.05). There was a trend for a higher AUC value for mP(alpha) compared with BMD of the spine (AUC=0.71; p=0.81).
mP(alpha) yielded a robust measure of trabecular bone microarchitecture for HR-MR images of the radius, which significantly improved the diagnostic performance in differentiating postmenopausal women with and without osteoporotic spine fractures compared with standard 2D bone histomorphometric parameters. This 3D characterization of trabecular microarchitecture may provide a new approach to better assess the strength of human cancellous bone using HR-MR image data.
本研究的目的是从高分辨率（HR）桡骨远端磁共振（MR）图像中获取不同的结构测量值，如基于三维（3D）的缩放指数法（SIM）和标准二维（2D）骨组织形态计量学参数，并比较这些参数与骨密度（BMD）在鉴别绝经后有和无椎体骨折患者时的诊断性能。
对40名绝经后女性（17名患有骨质疏松性脊柱骨折，23名作为对照）进行1.5T的桡骨远端轴向HR-MR成像。使用源自SIM的新结构测量值mP(alpha)以及标准形态学2D参数进行小梁微结构分析。使用定量计算机断层扫描（QCT）获取脊柱的BMD。采用受试者操作特征（ROC）分析来确定区分两组的诊断性能。结果通过自抽样技术进行验证。
使用mP(alpha)、2D参数和脊柱BMD在两组患者之间获得了显著差异（p<0.05）。与2D纹理参数相比（曲线下面积（AUC）高达0.67），mP(alpha)的诊断性能显著更高（AUC=0.85；p<0.05）。与脊柱BMD相比（AUC=0.71；p=0.81），mP(alpha)有更高AUC值的趋势。
mP(alpha)为桡骨HR-MR图像的小梁骨微结构提供了可靠的测量方法，与标准2D骨组织形态计量学参数相比，在鉴别绝经后有和无骨质疏松性脊柱骨折的女性时显著提高了诊断性能。这种小梁微结构的3D表征可能为利用HR-MR图像数据更好地评估人体松质骨强度提供一种新方法。
