Miller Larry E, Ramp Warren K, Steele Charles R, Nickols-Richardson Sharon M, Herbert William G
Miller Scientific Consulting, Arden, NC, USA.
J Med Eng Technol. 2013 Feb;37(2):144-9. doi: 10.3109/03091902.2012.753128.
Prediction of osteoporotic fractures is currently an imperfect science and new tools are desperately needed to identify at-risk patients at an earlier stage in the disease process. The mechanical response tissue analyser (MRTA) is a novel, non-invasive, radiation-free device that measures the bending stiffness of long bones in vivo, an indicator of a bone's ability to resist deformation under a given load and a strong predictor of long bone structural integrity and strength. Bone bending stiffness measured with the MRTA has been consistently shown to be a stronger predictor of post-mortem and ex vivo bone breaking strength compared to bone mineral measured with dual-energy X-ray absorptiometry. Bone bending stiffness measured with MRTA also decreases with advanced age and disease states and increases with chronic physical activity, independent of bone mineral changes. The MRTA measures different parameters than DXA (bone quality vs bone mineral content and density) and may be a more robust tool for identifying those at risk for fracture. Research initiatives focused on improving long-term repeatability and optimizing the signal-to-noise ratio of the measurement are currently underway to further advance the clinical usefulness of this technology.
目前，骨质疏松性骨折的预测尚不完善，亟需新工具在疾病进程的早期阶段识别出高危患者。机械反应组织分析仪（MRTA）是一种新型的、非侵入性的、无辐射的设备，可在体内测量长骨的弯曲刚度，弯曲刚度是指骨骼在给定负荷下抵抗变形的能力，也是长骨结构完整性和强度的有力预测指标。与双能X线吸收法测量的骨矿物质相比，用MRTA测量的骨弯曲刚度一直被证明是死后和体外骨断裂强度的更强预测指标。用MRTA测量的骨弯曲刚度也会随着年龄增长和疾病状态而降低，并随着长期体育活动而增加，且与骨矿物质变化无关。MRTA测量的参数与双能X线吸收法不同（骨质量与骨矿物质含量和密度），可能是识别骨折高危人群的更可靠工具。目前正在开展研究项目，致力于提高长期重复性并优化测量的信噪比，以进一步提升这项技术的临床实用性。
