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青少年胫骨和股骨骨骺的扩散张量成像比较

Comparison of tibial and femoral physeal diffusion tensor imaging in adolescents.

作者信息

Santos Laura, Guariento Andressa, Moustoufi-Moab Sogol, Nguyen Jie, Tokaria Rumana, Raya Jose Maria, Zurakowski David, Jambawalikar Sachin, Jaramillo Diego

机构信息

Columbia University Medical Center, 622 W 168Th St, New York, NY, 10032, USA.

Children's Hospital of Philadelphia, Philadelphia, PA, USA.

出版信息

Pediatr Radiol. 2024 Dec;54(13):2243-2253. doi: 10.1007/s00247-024-06073-6. Epub 2024 Nov 9.

Abstract

BACKGROUND

Distal femoral diffusion tensor imaging (DTI) is a predictor of height gain but it is uncertain whether DTI can demonstrate differences in growth potential between the tibia and femur.

OBJECTIVE

To explore the differences in structure and growth potential of the proximal tibia physeal-metaphyseal complex compared to those of the distal femur through DTI tractographic characterization and DTI metric comparison.

MATERIALS AND METHODS

Prospective cross-sectional study involved 108 healthy children (59 females) aged 8-14 years (females) and 10-16 years (males) around the growth spurt. We acquired knee DTI once at 3 T with b-values of 0 s/mm and 600 s/mm. Tract parameters including number, length, volume, and fractional anisotropy were measured. Regression analysis with linear and negative binomial models, incorporating bone age-based quadratic fitting, characterized DTI parameter changes in relation to bone age and sex, as well as variations between physes. Femorotibial ratios were calculated based on paired DTI parameter absolute values during peak height gain. The study was approved by the institutional review board of two tertiary pediatric centers in compliance with the Health Insurance Portability and Accountability Act.

RESULTS

Proximal tibial tracts were more numerous in the central physis, whereas distal femoral tracts predominated peripherally. Tract volume rose and fell during adolescence and peaked earlier in females (140-160 months vs. 160-180 months, P=0.02). At maximal height velocity (160 months), tibial tract volume (5.43 cc) was 37.4% of total knee tract volume (14.53 cc). Tibial fractional anisotropy decreased and then increased, both earlier than the femur.

CONCLUSION

Proximal tibial and distal femoral tract distributions differ. The tibia accounts for 37.4% of total knee tract volume during maximal height velocity. Tract volumes rise and fall, earlier in females. Tibiofemoral ratios of DTI metrics resemble known ratios of growth rates between tibia and femur.

摘要

背景

股骨远端扩散张量成像(DTI)是身高增长的一个预测指标,但DTI能否显示胫骨和股骨之间生长潜力的差异尚不确定。

目的

通过DTI纤维束成像特征和DTI指标比较,探讨胫骨近端干骺端复合体与股骨远端在结构和生长潜力上的差异。

材料与方法

前瞻性横断面研究纳入了108名健康儿童,其中女性59名,年龄在8 - 14岁(女性)和10 - 16岁(男性),处于生长突增期前后。我们在3T磁共振成像仪上采集一次膝关节DTI图像,b值分别为0 s/mm和600 s/mm。测量纤维束参数,包括数量、长度、体积和各向异性分数。采用线性和负二项式模型进行回归分析,并结合基于骨龄的二次拟合,描述DTI参数随骨龄和性别的变化,以及不同骨骺之间的差异。在身高增长高峰期,根据配对的DTI参数绝对值计算股胫比。该研究经两家三级儿科中心的机构审查委员会批准,符合《健康保险流通与责任法案》。

结果

胫骨近端纤维束在中央骨骺处较多,而股骨远端纤维束在外围占主导。纤维束体积在青春期先增加后减少,且在女性中达到峰值的时间更早(140 - 160个月 vs. 160 - 180个月,P = 0.02)。在最大身高增长速度时(160个月),胫骨纤维束体积(5.43立方厘米)占膝关节总纤维束体积(14.53立方厘米)的37.4%。胫骨各向异性分数先降低后升高,且均早于股骨。

结论

胫骨近端和股骨远端的纤维束分布不同。在最大身高增长速度时,胫骨占膝关节总纤维束体积的37.4%。纤维束体积先增加后减少,在女性中出现得更早。DTI指标的股胫比类似于已知的胫骨和股骨生长速率之比。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/523e/11638376/0daab506d334/247_2024_6073_Fig1_HTML.jpg

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