患有神经性厌食症的女性：应用平板容积 CT 的有限元与小梁结构分析。
Women with anorexia nervosa: finite element and trabecular structure analysis by using flat-panel volume CT.
机构信息
Department of Mechanical Engineering, Massachusetts Institute of Technology, Room 3-470, Cambridge, MA 02139, USA.
出版信息
Radiology. 2010 Oct;257(1):167-74. doi: 10.1148/radiol.10100222. Epub 2010 Aug 16.
PURPOSE
To use finite element modeling based on flat-panel volume computed tomography (CT) and bone mineral density (BMD) provided by dual-energy x-ray absorptiometry (DXA) to compare bone failure load, stiffness, and trabecular structure in women with anorexia nervosa (AN) and age-matched normal-weight control subjects.
MATERIALS AND METHODS
The study was approved by the institutional review board and complied with HIPAA guidelines. Informed consent was obtained. Fourteen women, eight with AN (mean age, 26.6 years) and six control subjects (mean age, 26.3 years), underwent flat-panel volume CT of the distal radius to determine apparent trabecular bone volume fraction (BV/TV), apparent trabecular number (TbN), apparent trabecular thickness (TbTh), and apparent trabecular separation (TbSp). Bone strength and stiffness were calculated from uniaxial compression tests by using finite element models created from flat-panel volume CT. DXA was used to determine BMD of the radius, lumbar spine, and hip. Means ± standard deviations of all variables were calculated for both groups and compared (Student t test). Univariate regression analysis and stepwise regression modeling were performed.
RESULTS
Patients with AN had lower values for stiffness (284.77 kN/mm ± 76.14 vs 389.97 kN/mm ± 84.90, P = .04), failure load (4.98 kN ± 1.23 vs 7.01 kN ± 1.52, P = .02), BV/TV (0.32% ± 0.09 vs 0.44% ± 0.02, P = .007), and TbN (1.15 mm(-3) ± 0.20 vs 1.43 mm(-3) ± 0.13, P = .008) and higher values for TbSp (0.62 mm ± 0.20 vs 0.40 mm ± 0.04, P = .02) compared with normal-weight control subjects. TbTh was lower in women with AN (P = .1). BMD measurements were significantly lower for the AN group. BMD measurements and trabecular parameters (except TbTh) correlated with stiffness and failure load (r = 0.58 to 0.83).
CONCLUSION
Failure load and stiffness are abnormal in women with AN compared with those in normal-weight control subjects and correlate with BMD and trabecular parameters.
目的
使用基于平板容积 CT 和双能 X 线吸收法（DXA）提供的骨密度（BMD）的有限元建模，比较神经性厌食症（AN）女性与年龄匹配的正常体重对照受试者的骨失效负荷、刚度和小梁结构。
材料和方法
该研究获得机构审查委员会批准，并符合 HIPAA 指南。获得了知情同意。14 名女性，8 名患有 AN（平均年龄 26.6 岁）和 6 名对照受试者（平均年龄 26.3 岁）接受了远端桡骨平板容积 CT 检查，以确定表观小梁骨体积分数（BV/TV）、表观小梁数量（TbN）、表观小梁厚度（TbTh）和表观小梁分离（TbSp）。通过使用平板容积 CT 创建的有限元模型，从单轴压缩试验中计算骨强度和刚度。DXA 用于确定桡骨、腰椎和髋部的 BMD。计算两组所有变量的平均值±标准差，并进行比较（Student t 检验）。进行单变量回归分析和逐步回归建模。
结果
患有 AN 的患者刚度值较低（284.77 kN/mm ± 76.14 与 389.97 kN/mm ± 84.90，P =.04），失效负荷较低（4.98 kN ± 1.23 与 7.01 kN ± 1.52，P =.02），BV/TV 值较低（0.32% ± 0.09 与 0.44% ± 0.02，P =.007），TbN 值较低（1.15 mm(-3) ± 0.20 与 1.43 mm(-3) ± 0.13，P =.008）和 TbSp 值较高（0.62 mm ± 0.20 与 0.40 mm ± 0.04，P =.02），与正常体重对照受试者相比。患有 AN 的女性 TbTh 较低（P =.1）。AN 组的 BMD 测量值明显较低。BMD 测量值和小梁参数（除 TbTh 外）与刚度和失效负荷相关（r = 0.58 至 0.83）。
结论
与正常体重对照受试者相比，患有 AN 的女性失效负荷和刚度异常，与 BMD 和小梁参数相关。
Zotero 插件