The James Cook University Hospital, Middlesbrough, United Kingdom.
The James Cook University Hospital, Middlesbrough, United Kingdom; Musculoskeletal Research Group, Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, United Kingdom.
J Clin Densitom. 2020 Jul-Sep;23(3):418-425. doi: 10.1016/j.jocd.2019.05.005. Epub 2019 May 17.
The Mr F study investigates the pathogenesis of low trauma distal forearm fractures in men and includes volumetric bone mineral density (vBMD) measurements at the ultradistal forearm as there are no current data. A standard 64 slice CT scanner was used to determine if it was possible to adapt the existing Mindways quantitative computed tomography Pro software for measuring vBMD values at the hip and spine sites. For calculation of intra- and interobserver reliability 40 forearm scans out of the 300 available were chosen randomly. The images were analyzed using the Slice Pick module and Bone Investigational Toolkit. The 4% length of the radius was chosen by measuring the length of the radius from the scaphoid fossa distally to the radial head. The acquired image then underwent extraction, isolation, rotation, and selection of region of interest in order to generate a report on vBMD. A cross-sectional image was created to allow the generation of data on the cortical and trabecular components separately. Repeat analyses were undertaken by 3 independent observers who were blinded as to whether the image was from a participant with or without fracture. The images were presented in random order at each time point. The following parameters were recorded: cortical cross sectional area, total vBMD, trabecular vBMD, and cortical vBMD (CvBMD). Data were analyzed by calculating intraclass correlation coefficients for intra- and interobserver reliability. The lowest values occurred at the CvBMD with intraobserver reliability of 0.92 (95% confidence interval [CI] of 0.86-0.96) and interobserver reliability of 0.92 (95% CI 0.89-0.96). All other parameters had reliability values between 0.97 and 0.99 with tighter 95% CI than for CvBMD. The method of adapting the Mindways Pro software using a standard CT to produce vBMD and structural data at the ultradistal radius is reliable.
Mr F 研究旨在探究男性低创伤性远端前臂骨折的发病机制，包括对超远端前臂进行容积骨密度（vBMD）测量，因为目前尚无相关数据。该研究使用标准的 64 排 CT 扫描仪，以确定是否可以调整现有的 Mindways 定量计算机断层扫描 Pro 软件，以测量髋关节和脊柱部位的 vBMD 值。为了计算观察者内和观察者间的可靠性，从 300 个可用的前臂扫描中随机选择了 40 个进行分析。使用 Slice Pick 模块和 Bone Investigational Toolkit 分析图像。通过测量从舟状窝远端到桡骨头的桡骨长度，选择桡骨的 4%长度。然后，对获得的图像进行提取、分离、旋转和感兴趣区域选择，以生成 vBMD 报告。创建一个横断图像，以便分别生成皮质和小梁成分的数据。3 名独立观察者进行了重复分析，他们对图像是来自骨折患者还是无骨折患者并不知情。在每个时间点，图像以随机顺序呈现。记录以下参数：皮质横截面积、总 vBMD、小梁 vBMD 和皮质 vBMD（CvBMD）。通过计算观察者内和观察者间可靠性的组内相关系数来分析数据。最低值出现在 CvBMD 中，观察者内可靠性为 0.92（95%置信区间 [CI] 为 0.86-0.96），观察者间可靠性为 0.92（95%CI 为 0.89-0.96）。所有其他参数的可靠性值在 0.97 到 0.99 之间，95%CI 比 CvBMD 更紧。使用标准 CT 通过 Mindways Pro 软件调整来生成超远端桡骨的 vBMD 和结构数据的方法是可靠的。
