Nishiyama Kyle K, Boyd Steven K
Schulich School of Engineering, Roger Jackson Centre for Health and Wellness Research, University of Calgary, Calgary, Canada.
Clin Calcium. 2011 Jul;21(7):1011-9.
In addition to bone mineral density (BMD), bone microstructure is a major contributor to bone strength. With recently developed technologies we are able to assess bone microstructure in vivo . These technologies include high-resolution peripheral quantitative computed tomography (HR-pQCT), multi-detector computer tomography (MDCT), and high-resolution magnetic resonance imaging (HR-MRI). Using HR-pQCT both cortical and trabecular microstructure can be assessed with a voxel size of 82μm. While MDCT and HR-MRI have lower spatial resolution than HR-pQCT, they have the main advantage of imaging central sites such as the proximal femur. Using these technologies a variety of parameters can be measured including bone volume ratio, trabecular thickness and number, cortical thickness, and cortical porosity. In vivo microstructure measurements are associated with fracture risk and these measurements can be combined with finite element modeling to estimate bone strength. While limitations exist, such as measurement of only peripheral sites and motion artifacts, the assessment of microstructure is promising and provides clinically relevant information. The techniques may help to better predict fracture risk and determine the efficacy of treatments for metabolic bone diseases.
除骨矿物质密度（BMD）外，骨微结构也是骨强度的主要决定因素。借助最近开发的技术，我们能够在体内评估骨微结构。这些技术包括高分辨率外周定量计算机断层扫描（HR-pQCT）、多探测器计算机断层扫描（MDCT）和高分辨率磁共振成像（HR-MRI）。使用HR-pQCT，皮质骨和小梁骨微结构均可通过82μm的体素大小进行评估。虽然MDCT和HR-MRI的空间分辨率低于HR-pQCT，但它们的主要优势在于能够对诸如股骨近端等中心部位进行成像。使用这些技术可以测量多种参数，包括骨体积比、小梁厚度和数量、皮质厚度以及皮质孔隙率。体内微结构测量与骨折风险相关，并且这些测量结果可以与有限元模型相结合以估计骨强度。尽管存在局限性，例如仅测量外周部位以及运动伪影，但微结构评估前景广阔，并能提供临床相关信息。这些技术可能有助于更好地预测骨折风险并确定代谢性骨病治疗的疗效。
