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DOI: 10.1055/s-2004-813078
© Georg Thieme Verlag Stuttgart · New York
Mehrschicht-CT zur Strukturanalyse des trabekulären Knochens - Vergleich mit Mikro-CT und biomechanischer Festigkeit
Multislice-CT for Structure - Analysis of Trabecular Bone - a Comparison with Micro-CT and Biomechanical StrengthPublication History
Publication Date:
06 May 2004 (online)
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Zusammenfassung
Ziel: Im Vergleich zur Einschicht-Spiral-CT (ES-CT) hat die Mehrschicht-CT (MS-CT) eine deutlich höhere Ortsauflösung. Ziel dieser Studie war es daher zu prüfen, ob der Zugewinn an Auflösung Vorteile für die Knochenstrukturanalyse in der Osteoporosediagnostik bietet. Material und Methoden: 20 zylinderförmige, trabekuläre Knochenproben (Durchmesser 12 mm, Länge 15 - 20 mm) wurden humanen thorakalen Wirbelsäulenpräparaten (BWK 8) entnommen. Mittels ES- und MS-CT wurden hochauflösende Schnittbilder angefertigt und histomorphometrische Strukturparameter errechnet. Zusätzlich wurde die Knochenmineraldichte (BMD) mittels quantitativer CT bestimmt. Als Goldstandard dienten analoge Strukturparameter aus der Mikro-CT und die biomechanisch bestimmte Versagensspannung (VS) der Proben. Ergebnisse: Die Parameter Knochenvolumenfraktion und trabekuläre Separation aus dem ES- und MS-CT korrelierten hoch mit den entsprechenden Strukturparametern aus der Mikro-CT (bis r2 = 0,84; p < 0,01) und mit der VS (bis r2 = 0,81; p < 0,01). Die höchste Korrelation mit der VS ergab sich für den Parameter trabekuläre Anzahl aus dem MS-CT (r2 = 0,85, p < 0,01). Diese war signifikant (p < 0,05) höher als die Korrelation zwischen VS und BMD (r2 = 0,49). Schlussfolgerung: Mit der MS-CT gemessene Strukturparameter des trabekulären Knochens zeigen hohe Korrelationen mit der Mikro-CT, so dass eine klinische Charakterisierung der trabekulären Struktur möglich erscheint. Mittels MS-CT akquirierte Strukturparameter waren in dieser experimentellen Studie für die Vorhersage der biomechanischen Festigkeit am besten geeignet.
Abstract
Objectives: MS-CT (Multislice-Spiral-CT) has a higher spatial resolution compared to the SS-CT (Singleslice-CT). The purpose of this study was to investigate, if the higher spatial resolution of the MS-CT has advantages for structural analyses in the assessment of osteoporosis. Material and Methods: 20 cylindrical trabecular bone specimens (diameter 12 mm, length 15 - 20 mm) were harvested from formalin-fixed human thoracic spines. All specimens were examined by Micro-CT and quantitative, histomorphologic parameters were determined. Analogous structural parameters were calculated from the high-resolution images acquired by both MS- and SS-CT. Additionally, the BMD (bone mineral density) was measured by QCT (quantitative CT). The maximum compressive strength (MCS) was determined in a biomechanical test. The structural parameters were correlated with the histomorphologic parameters and with the MCS. Results: The parameters bone fraction and trabecular separation correlated significantly in both MS- and SS-CT with the analogous parameters from Micro-CT (r2 = 0.84, p < 0.01) and the MCS (r2 = 0.81, p < 0.01). The highest correlation with the MCS was calculated using the trabecular number measured by MS-CT in the superior region near the endplate of the vertebra with the high-resolution kernel U90 u (r2 = 0.85, p < 0.01). This correlation was significantly higher than the correlation between MCS and BMD (r2 = 0.49, p < 0.01). Conclusion: Micro-CT- and MS-CT-determined structural parameters of the trabecular bone showed significant, high correlations. Thus, a characterisation of the trabecular structure seems to be possible. The biomechanical stability of the bone can also be predicted well. The structural parameters acquired by MS-CT show higher correlations with the MCS than the BMD or structural parameters determined by SS-CT do. In this study MS-CT was best suited to predict biomechanical strength of trabecular bone.
Key words
Computed tomography (CT) - multi-detector row - bones - spine - osteoporosis
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Prof. Dr. med. Thomas M. Link
Department of Radiology at UCSF
400 Parnassus Ave
Box 0628
San Francisco, CA 94143, USA
Email: tmlink@radiology.ucsf.com