无假体定量计算机断层扫描有限元建模得出的椎体骨折风险阈值与基于假体的结果相关联

IF 1.7 4区 医学 Q4 ENDOCRINOLOGY & METABOLISM
Maria Prado , Sundeep Khosla , Hugo Giambini
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引用次数: 0

摘要

导言:骨质疏松症是指骨骼质量下降导致骨骼变弱,易发生骨折。双能 X 射线吸收测量法无法评估骨强度。定量计算机断层扫描(QCT)的容积骨矿物质密度(vBMD)已被用于制定骨质疏松症的等效测量指南。基于 QCT 的有限元分析 (FEA) 已利用校准模型实施,以根据已建立的 vBMD 确定骨强度阈值。主要目的是使用无模型方法与之前建立的阈值验证椎体破坏载荷阈值,推进无模型方法用于骨折风险预测:方法:使用基于 QCT/FEA 的无模型校准方法和两种材料方程,对 108 名受试者(68 名女性)进行对照队列,以验证正常、骨质疏松和骨质疏松受试者的特定性别椎体骨折载荷阈值:基于两个方程的无模型方法和基于模型的方法之间具有很强的预测相关性(R2:男性为 0.95 和 0.97,女性为 0.96 和 0.98)。布兰德-阿尔特曼图和配对 t 检验表明,两种方法之间没有显著差异。使用无假体方法预测的骨强度和阈值与使用假体校准获得的结果以及之前确定的结果一致,女性骨强度≤4500 N(脆性)和≥6000 N(正常),男性骨强度≤6500 N(脆性)和≥8500 N(正常):基于无影 QCT 的有限元分析可用于前瞻性和回顾性研究,评估脊柱意外椎体骨折风险及其与脊柱弯曲和/或骨折病因的关联。这项研究的结果进一步支持了基于无模型 QCT 的有限元分析模型在预测椎体强度方面的应用,有助于识别易发生骨折的个体。这加强了采用这种方法作为预测和管理骨折风险的综合方法的合理性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Vertebral Fracture Risk Thresholds from Phantom-Less Quantitative Computed Tomography-Based Finite Element Modeling Correlate to Phantom-Based Outcomes

Introduction: Osteoporosis indicates weakened bones and heightened fracture susceptibility due to diminished bone quality. Dual-energy x-ray absorptiometry is unable to assess bone strength. Volumetric bone mineral density (vBMD) from quantitative computed tomography (QCT) has been used to establish guidelines as equivalent measurements for osteoporosis. QCT-based finite element analysis (FEA) has been implemented using calibration phantoms to establish bone strength thresholds based on the established vBMD. The primary aim was to validate vertebral failure load thresholds using a phantom-less approach with previously established thresholds, advancing a phantom-free approach for fracture risk prediction.

Methodology: A controlled cohort of 108 subjects (68 females) was used to validate sex-specific vertebral fracture load thresholds for normal, osteopenic, and osteoporotic subjects, obtained using a QCT/FEA-based phantom-less calibration approach and two material equations.

Results: There were strong prediction correlations between the phantom-less and phantom-based methods (R2: 0.95 and 0.97 for males, and R2: 0.96 and 0.98 for females) based on the two equations. Bland Altman plots and paired t-tests showed no significant differences between methods. Predictions for bone strengths and thresholds using the phantom-less method matched those obtained using the phantom calibration and those previously established, with ≤4500 N (fragile) and ≥6000 N (normal) bone strength in females, and ≤6500 N (fragile) and ≥8500 N (normal) bone strength in males.

Conclusion: Phantom-less QCT-based FEA can allow for prospective and retrospective studies evaluating incidental vertebral fracture risk along the spine and their association with spine curvature and/or fracture etiology. The findings of this study further supported the application of phantom-less QCT-based FEA modeling to predict vertebral strength, aiding in identifying individuals prone to fractures. This reinforces the rationale for adopting this method as a comprehensive approach in predicting and managing fracture risk.

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来源期刊
Journal of Clinical Densitometry
Journal of Clinical Densitometry 医学-内分泌学与代谢
CiteScore
4.90
自引率
8.00%
发文量
92
审稿时长
90 days
期刊介绍: The Journal is committed to serving ISCD''s mission - the education of heterogenous physician specialties and technologists who are involved in the clinical assessment of skeletal health. The focus of JCD is bone mass measurement, including epidemiology of bone mass, how drugs and diseases alter bone mass, new techniques and quality assurance in bone mass imaging technologies, and bone mass health/economics. Combining high quality research and review articles with sound, practice-oriented advice, JCD meets the diverse diagnostic and management needs of radiologists, endocrinologists, nephrologists, rheumatologists, gynecologists, family physicians, internists, and technologists whose patients require diagnostic clinical densitometry for therapeutic management.
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