Weldon School of Biomedical Engineering, Purdue University, 206 S. Martin Jischke Dr., West Lafayette, IN, 47907, USA.
Department of Radiology and Imaging Sciences, Indiana University School of Medicine, 550 N. University Blvd., Indianapolis, IN, 46202, USA.
Curr Osteoporos Rep. 2024 Feb;22(1):56-68. doi: 10.1007/s11914-023-00856-w. Epub 2024 Jan 16.
This review summarizes recent advances in the assessment of bone quality using non-X-ray techniques.
Quantitative ultrasound (QUS) provides multiple measurements of bone characteristics based on the propagation of sound through bone, the attenuation of that sound, and different processing techniques. QUS parameters and model predictions based on backscattered signals can discriminate non-fracture from fracture cases with accuracy comparable to standard bone mineral density (BMD). With advances in magnetic resonance imaging (MRI), bound water and pore water, or a porosity index, can be quantified in several long bones in vivo. Since such imaging-derived measurements correlate with the fracture resistance of bone, they potentially provide new BMD-independent predictors of fracture risk. While numerous measurements of mineral, organic matrix, and bound water by Raman spectroscopy correlate with the strength and toughness of cortical bone, the clinical assessment of person's bone quality using spatially offset Raman spectroscopy (SORS) requires advanced spectral processing techniques that minimize contaminating signals from fat, skin, and blood. Limiting exposure of patients to ionizing radiation, QUS, MRI, and SORS has the potential to improve the assessment of fracture risk and track changes of new therapies that target bone matrix and micro-structure.
本文总结了近年来非 X 射线技术评估骨质量的新进展。
超声定量（QUS）技术通过检测声波在骨骼中的传播、衰减和不同的处理技术，提供了多种骨骼特征的测量方法。基于背向散射信号的 QUS 参数和模型预测可以准确地区分非骨折和骨折病例，其准确性可与标准骨密度（BMD）相媲美。随着磁共振成像（MRI）技术的进步，可在几处长骨中对结合水和孔内水或孔隙指数进行定量检测。由于这些成像衍生的测量方法与骨的抗断裂能力相关，因此它们可能为骨折风险提供新的 BMD 独立预测因子。虽然拉曼光谱对矿物质、有机基质和结合水的多项测量与皮质骨的强度和韧性相关，但使用空间偏移拉曼光谱（SORS）对个体骨质量的临床评估需要先进的光谱处理技术，以最小化来自脂肪、皮肤和血液的污染信号。限制患者接受电离辐射，QUS、MRI 和 SORS 有可能改善骨折风险评估，并跟踪针对骨基质和微观结构的新疗法的效果。
