Center for Bone Quality, Leiden University Medical Center, Leiden, The Netherlands.
J Bone Miner Res. 2017 Dec;32(12):2375-2380. doi: 10.1002/jbmr.3239. Epub 2017 Oct 16.
Impact microindentation (IMI) is a new technique for the in vivo measurement of tissue-level properties of cortical bone in humans. To address issues related to the proper application of IMI in clinical practice and to directly examine cortical bone properties in patients with tibia pathology, we studied 11 subjects without tibia pathology and nine patients with Paget's disease of the tibia in biochemical remission after bisphosphonate treatment. Serial indentations in the tibias of both legs were performed in all subjects by a single operator until 10 adequate measurements were obtained in each tibia. In patients without Paget's disease (7 men and 4 women; mean age, 61.9 years; range, 51 to 72 years), there was no difference in mean bone material strength index (BMSi) between the dominant and nondominant leg (82.1 ± 1.3 and 81.4 ± 1.3, respectively; p = 0.606). In each individual subject studied, sequential indentations in both legs showed no trends for higher or lower values with time. The standard deviation of unnormalized bone material strength (BMSu) was also comparable between the dominant and nondominant tibia (5.3 and 4.5, respectively; p = 0.657). In patients with Paget's disease (4 men and 5 women; mean age, 69.5 years; range, 55 to 87 years), mean BMSi of the Pagetic tibia was lower, albeit nonsignificantly, than that of the contralateral nonaffected tibia (74.7 ± 1.7 and 78.7 ± 1.3, respectively; p = 0.120). In contrast to subjects without Paget's disease, the SD of adequate BMSu values was significantly larger in the Pagetic tibia compared to that of the non-Pagetic tibia (7.6 versus 5.0, respectively, p = 0.008). These results highlight the consistency of serial IMI measurements as performed by a single operator in the presence as well as absence of tibia pathology and illustrate that the method is able to capture alterations of tissue-level cortical bone properties in patients with Paget's disease of the tibia. © 2017 The Authors.Journal of Bone and Mineral Research Published by Wiley Periodicals Inc.
冲击微压痕（IMI）是一种新的技术，可用于测量人体皮质骨的组织水平特性。为了解决 IMI 在临床实践中的正确应用问题，并直接检查患有胫骨病变患者的皮质骨特性，我们研究了 11 名无胫骨病变的受试者和 9 名经双膦酸盐治疗后处于生化缓解期的胫骨 Paget 病患者。由一名操作者对所有受试者的双侧胫骨进行连续压痕，直到在每根胫骨上获得 10 个足够的测量值。在无 Paget 病的患者（7 名男性和 4 名女性；平均年龄 61.9 岁；范围 51 至 72 岁）中，优势侧和非优势侧胫骨的平均骨材料强度指数（BMSi）没有差异（分别为 82.1 ± 1.3 和 81.4 ± 1.3；p = 0.606）。在每个单独研究的受试者中，双侧胫骨的连续压痕随时间没有表现出更高或更低值的趋势。优势侧和非优势侧胫骨的未归一化骨材料强度（BMSu）的标准差也相似（分别为 5.3 和 4.5；p = 0.657）。在 Paget 病患者中（4 名男性和 5 名女性；平均年龄 69.5 岁；范围 55 至 87 岁），Pagetic 胫骨的平均 BMSi 虽然无统计学意义但低于对侧非受累胫骨（分别为 74.7 ± 1.7 和 78.7 ± 1.3；p = 0.120）。与无 Paget 病的患者不同，Pagetic 胫骨的适当 BMSu 值的标准差明显大于非 Pagetic 胫骨（分别为 7.6 和 5.0；p = 0.008）。这些结果突出了在存在和不存在胫骨病变的情况下，由单一操作者进行的连续 IMI 测量的一致性，并说明了该方法能够捕获患有胫骨 Paget 病患者的组织水平皮质骨特性的变化。© 2017 作者。由 Wiley Periodicals Inc. 出版的《骨与矿物研究杂志》
