Orthopaedic Surgery, Orthopedic Biomechanics Laboratory, Beth Israel Deaconess Medical Center and Department of Orthopaedic Surgery, Harvard Medical School, RN115, 330 Brookline Ave, Boston, MA 02215, USA.
Best Pract Res Clin Rheumatol. 2009 Dec;23(6):741-53. doi: 10.1016/j.berh.2009.09.008.
The ability of a bone to resist fracture depends on the amount of bone present, the spatial distribution of the bone mass as cortical and trabecular bone and the intrinsic properties of the bone material. Whereas low areal bone mineral density (aBMD) predicts fractures, its sensitivity and specificity is low, as over 50% of fractures occur in persons without osteoporosis by BMD testing and most women with osteoporosis do not sustain a fracture. New non-invasive imaging techniques, including three-dimensional (3D) assessments of bone density and geometry, microarchitecture and integrated measurements of bone strength such as finite element analysis (FEA), provide estimates of bone strength that can be used to increase the sensitivity and specificity of fracture risk assessment. Initial observations have shown that these techniques provide information that will improve our understanding of the pathophysiology of skeletal fragility and suggest that these techniques are likely to have a role in the clinical management of individuals at risk for fracture.
骨骼的抗骨折能力取决于骨量的多少、皮质骨和松质骨的空间分布以及骨材料的固有特性。虽然低骨面积密度 (aBMD) 可预测骨折，但它的敏感性和特异性较低，因为超过 50%的骨折发生在 BMD 检测无骨质疏松症的人群中，而且大多数患有骨质疏松症的女性不会发生骨折。新的非侵入性成像技术，包括骨密度和几何形状的三维 (3D) 评估、微观结构以及骨强度的综合测量，如有限元分析 (FEA)，可提供骨强度的估计值，从而提高骨折风险评估的敏感性和特异性。初步观察表明，这些技术提供的信息将有助于我们理解骨骼脆弱的病理生理学，并表明这些技术可能在骨折风险个体的临床管理中发挥作用。
