Department of Biomechanical Engineering, Delft University of Technology, Delft, The Netherlands.
Department of In-Body Systems, Philips Research, Royal Philips, NV, Eindhoven, The Netherlands.
Biomed Eng Online. 2021 Jan 7;20(1):7. doi: 10.1186/s12938-020-00846-4.
The increased popularity of minimally invasive spinal surgery calls for a revision of guidance techniques to prevent injuries of nearby neural and vascular structures. Lipid content has previously been proposed as a distinguishing criterion for different bone tissues to provide guidance along the interface of cancellous and cortical bone. This study aims to investigate how fat is distributed throughout the spinal column to confirm or refute the suitability of lipid content for guidance purposes.
Proton density fat fraction (PDFF) was assessed over all vertebral levels for six human cadavers between 53 and 92 years of age, based on fat and water MR images. According to their distance to the vertebra contour, the data points were grouped in five regions of interest (ROIs): cortical bone (-1 mm to 0 mm), pre-cortical zone (PCZ) 1-3 (0-1 mm; 1-2 mm; 2-3 mm), and cancellous bone ([Formula: see text] 3 mm). For PCZ1 vs. PCZ2, a significant difference in mean PDFF of between -7.59 pp and -4.39 pp on average was found. For cortical bone vs. PCZ1, a significant difference in mean PDFF of between -27.09 pp and -18.96 pp on average was found.
A relationship between distance from the cortical bone boundary and lipid content could be established, paving the way for guidance techniques based on fat fraction detection for spinal surgery.
微创脊柱手术的普及要求对引导技术进行修订，以防止邻近的神经和血管结构受伤。脂质含量先前已被提议作为区分不同骨组织的标准，以在松质骨和皮质骨的界面提供引导。本研究旨在调查脂肪在整个脊柱中的分布情况，以确认或否定脂质含量作为引导目的的适用性。
根据脂肪和水磁共振图像，对 6 具年龄在 53 至 92 岁之间的人体尸体的所有椎骨水平进行了质子密度脂肪分数（PDFF）评估。根据其与椎骨轮廓的距离，数据点被分为 5 个感兴趣区（ROI）：皮质骨（-1mm 至 0mm）、皮质前区（PCZ）1-3（0-1mm；1-2mm；2-3mm）和松质骨（[Formula: see text] 3mm）。对于 PCZ1 与 PCZ2，发现平均 PDFF 存在显著差异，平均差异在-7.59 pp 至-4.39 pp 之间。对于皮质骨与 PCZ1，发现平均 PDFF 存在显著差异，平均差异在-27.09 pp 至-18.96 pp 之间。
可以建立从皮质骨边界到脂质含量的距离之间的关系，为基于脂肪分数检测的脊柱手术引导技术铺平道路。
