Zhang Xiaoliu, Letuchy Elena M, Levy Steven M, Torner James C, Saha Punam K
Department of Electrical and Computer Engineering, University of Iowa, USA.
College of Public Health, University of Iowa, USA.
Proc SPIE Int Soc Opt Eng. 2020 Feb;11317. doi: 10.1117/12.2549881. Epub 2020 Feb 28.
Osteoporosis is a common age-related disease characterized by reduced bone mineral density (BMD), micro-structural deterioration, and enhanced fracture-risk. Although, BMD is clinically used to define osteoporosis, there are compelling evidences that bone micro-structural properties are strong determinants of bone strength and fracture-risk. Reliable measures of effective trabecular bone (Tb) micro-structural features are of paramount clinical significance. Tb consists of transverse and longitudinal micro-structures, and there is a hypothesis that transverse trabeculae improve bone strength by arresting buckling of longitudinal trabeculae. In this paper, we present an emerging clinical CT-based new method for characterizing transverse and longitudinal trabeculae, validate the method, and examine its application in human studies. Specifically, we examine repeat CT scan reproducibility, and evaluate the relationships of these measures with gender and body size using human CT data from the Iowa Bone Development Study (IBDS) (n = 99; 49 female). Based on a cadaveric ankle study (n = 12), both transverse and longitudinal Tb measures are found reproducible (ICC > 0.94). It was observed in the IBDS human data that males have significantly higher trabecular bone measures than females for both inner (p < 0.05) and outer (p < 0.01) regions of interest (ROIs). For weight, Spearman correlations ranged 0.43-0.48 for inner ROI measures and 0.50-0.52 for outer ROI measures for females versus 0.30-0.34 and 0.23-0.25 for males. Correlation with height was lower (0.36-0.39), but still mostly significant for females. No association of trabecular measures with height was found for males.
骨质疏松症是一种常见的与年龄相关的疾病，其特征是骨矿物质密度（BMD）降低、微观结构恶化以及骨折风险增加。尽管临床上使用BMD来定义骨质疏松症，但有确凿证据表明，骨微观结构特性是骨强度和骨折风险的重要决定因素。有效小梁骨（Tb）微观结构特征的可靠测量具有至关重要的临床意义。Tb由横向和纵向微观结构组成，有一种假说认为横向小梁通过阻止纵向小梁的屈曲来提高骨强度。在本文中，我们提出了一种基于临床CT的新兴方法来表征横向和纵向小梁，验证该方法，并研究其在人体研究中的应用。具体而言，我们检查重复CT扫描的可重复性，并使用来自爱荷华骨发育研究（IBDS）（n = 99；49名女性）的人体CT数据评估这些测量值与性别和体型的关系。基于一项尸体踝关节研究（n = 12），发现横向和纵向Tb测量值都是可重复的（组内相关系数> 0.94）。在IBDS人体数据中观察到，对于感兴趣的内部（p < 0.05）和外部（p < 0.01）区域，男性的小梁骨测量值显著高于女性。对于体重，女性内部感兴趣区域测量值的斯皮尔曼相关性范围为0.43 - 0.48，外部感兴趣区域测量值为0.50 - 0.52，而男性分别为0.30 - 0.34和0.23 - 0.25。与身高的相关性较低（0.36 - 0.39），但对女性来说大多仍然显著。未发现男性小梁测量值与身高之间存在关联。
