Osteoporosis is one of the common metabolic diseases, which can easily lead to osteoporotic fractures. Accurate prediction of bone biomechanical properties is of great significance for the early prevention and diagnosis of osteoporosis. Bone mineral density measurement is currently used clinically as the gold standard for assessing bone strength and diagnosing osteoporosis, but studies have shown that bone mineral density can only explain 60% to 70% of bone strength changes, and trabecular bone microstructure is an important factor affecting bone strength. In order to establish the connection between trabecular bone microstructure and bone strength, this paper proposes a prediction method of trabecular bone modulus based on SE-DenseVoxNet. This method takes three-dimensional binary images of trabecular bone as input and predicts its elastic modulus in the z-axis direction. Experiments show that the error and bias between the predicted value of the method and the true value of the sample are small and have good consistency.
Biomechanical Phenomena ; Bone Density ; Cancellous Bone/diagnostic imaging* ; Elastic Modulus ; Humans ; Osteoporosis/diagnostic imaging*

OBJECTIVE: To investigate the application value of apparent diffusion coefficient (ADC) and signal intensity ratio (SIR) of MR diffusion-weighted imaging (DWI) in quantitative evaluation of lumbar spine osteoporosis. METHODS: A total of 175 patients with lumbar spine diseases who received dualenergy X-ray absorption (DXA) bone mineral density (BMD), routine MRI and DWI of the lumbar spine from May 2017 to October 2019 were selected. According to the T-value of DXA, the patients were divided into osteoporosis group (64 cases), osteopenia group (53 cases) and normal bone mass group (58 cases). The ADC and SIR values of L RESULTS: There were statistically significant differences in ADC and SIR values among three groups ( CONCLUSION ADC and SIR can better reflect the BMD of patients with lumbar diseases, and can quantitatively evaluate the vertebral body of osteoporosis, which play an important role in the diagnosis of lumbar osteoporosis.
Diffusion Magnetic Resonance Imaging ; Humans ; Lumbar Vertebrae/diagnostic imaging* ; Magnetic Resonance Imaging ; Magnetic Resonance Spectroscopy ; Osteoporosis/diagnostic imaging*

OBJECTIVETo investigate the properties of screw-bone interface of expansive pedicle screw (EPS) in osteoporotic sheep by micro-CT and histological observation.

METHODSSix female sheep with bilateral ovariectomy-induced osteoporosis were employed in this experiment. After EPS insertion in each femoral condyle, the sheep were randomly divided into two groups: 3 sheep were bred for 3 months (Group A), while the other 3 were bred for 6 months (Group B). After the animals being killed, the femoral condyles with EPS were obtained, which were three-dimensionally-imaged and reconstructed by micro-CT. Histological evaluation was made thereafter.

RESULTSThe trabecular microstructure was denser at the screw-bone interface than in the distant parts in expansive section, especially within the spiral marking. In the non-expansive section, however, there was no significant difference between the interface and the distant parts. The regions of interest (ROI) adjacent to EPS were reconstructed and analyzed by micro-CT with the same thresholds. The three-dimensional (3-D) parameters, including tissue mineral density (TMD), bone volume fraction (BVF, BV/TV), bone surface/bone volume (BS/BV) ratio, trabecular thickness (Tb.Th), and trabecular separation (Tb.Sp), were significantly better in expansive sections than non-expansive sections (P less than 0.05). Histologically, newly-formed bony trabeculae crawled along the expansive fissures and into the center of EPS. The newly-formed bones, as well as the bones at the bone-screw interface, closely contacted with the EPS and constructed four compartments.

CONCLUSIONSThe findings of the current study, based on micro-CT and histological evaluation, suggest that EPS can significantly provide stabilization in osteoporotic cancellous bones.

Animals ; Bone Screws ; Bone and Bones ; diagnostic imaging ; pathology ; Female ; Osteoporosis ; diagnostic imaging ; pathology ; Sheep ; Tomography, X-Ray Computed

AIMTo establish bone mineral density (BMD) reference database in healthy Chinese men of Han ethnicity, and to estimate the prevalence of osteoporosis in the population.

METHODSThe BMD in the lumbar spine 1-4 (L1-4) and proximal femur was measured using dual energy X-ray absorptiometry in a total of 1 385 healthy Chinese men of Han ethnicity aged 20-89 years old in Shanghai.

RESULTSThe highly significant negative correlation between age and BMD at any sites of proximal femur was found in the studied population, wheras no correlation between age and BMD at lumbar spine was observed. The peak BMD of the lumbar spine and any sites of hip in Chinese men was defined as the mean BMD for the subjects aged 20-89 years. According to World Health Organization (WHO) criteria, the BMD cut-off values for osteoporosis of the L1-4, total hip, femoral neck, trochanter and intertrochanter in Chinese men are 0.719, 0.638, 0.575, 0.437 and 0.725 g/cm(2), respectively. Using the current Chinese reference data, the prevalence of osteoporosis at the L1-4, total hip, femoral neck, trochanter and intertrochanter is 5.4%, 3.8%, 6.3%, 1.8% and 2.8% in 1 084 men aged 50 years or older, respectively. However, using a database for US non-Hispanic white men (NHANES III), the prevalence of osteoporosis or osteopenia at any sites of the hip was significantly higher than that while using the current Chinese reference data.

CONCLUSIONThe BMD reference database was established in healthy Chinese men of Han ethnicity, and will facilitate more accurate diagnosis of osteoporosis in Chinese men.

Absorptiometry, Photon ; Adult ; Aged ; Aged, 80 and over ; Bone Density ; China ; epidemiology ; Femur ; diagnostic imaging ; Humans ; Male ; Middle Aged ; Osteoporosis ; diagnostic imaging ; epidemiology ; Prevalence ; Reference Values ; Spine ; diagnostic imaging

OBJECTIVE: To observe the effect of exogenous fat on the bone mineral density (BMD) of lumbar spine (LS) on a phantom measured by dual energy X-ray absorptiometry (DXA) Hologic QDR4500A. METHODS: LS DXA scans were performed on an LS phantom, and were repeated when with lard packets (2 fresh lard packets and 2 refined lard packets, 5 cm or 10 cm thick). RESULTS: After fresh lard packets were placed, only L1 BMD decreased significantly (P<0.05).When the 5 cm-thick refined lard packet was placed, BMD, bone mineral content (BMC),and bone area (BA) decreased obviously, but with the 10 cm-thick refined lard packet, BMD, BMC and BA decreased significantly (P<0.05 or P<0.01). CONCLUSION The exogenous fat may affect LS BMD of lumbar spine phantom by DXA Hologic QDR4500A, with significant decrease of the value,which may cause anomaly measurement of BMD in obese people and even misdiagnosis of osteoporosis.
Absorptiometry, Photon ; Adipose Tissue ; diagnostic imaging ; Body Composition ; Bone Density ; Humans ; Lumbar Vertebrae ; anatomy & histology ; diagnostic imaging ; Models, Biological ; Osteoporosis ; diagnostic imaging

OBJECTIVEUltrasound scanning can provide the information of acoustic impedance through the ultrasonic reflection theory. This study tries to introduce the application of the ultrasonic technique in predicting biomechanical properties of cancellous bone.

METHODSThe rat femoral head embedded in plexiglass was used as the bone specimens for ultrasound scanning and the gray scale images scanned by ultrasound microscope were collected and analyzed.

RESULTSThe value of acoustic impedance was calculated by analyzing the gray scale image.

CONCLUSIONThe application of ultrasonic microscopy can show more value about the microstructure of biomechanical properties of bone tissue.

Animals ; Biomechanical Phenomena ; Bone Density ; Femur Head ; diagnostic imaging ; physiology ; Microscopy, Acoustic ; methods ; Osteoporosis ; physiopathology ; Rats

OBJECTIVETo evaluate the efficacy and safety of percutaneous balloon kyphoplasty as a new therapy for patients with painful osteoporotic vertebral compressive fractures of the lumbar and thoracic spine.

METHODSA retrospective analysis was conducted in 38 consecutive patients (28 females, 10 males), whose ages ranged from 56 to 82 years (mean age 72 years). The symptom- and sign-positive spinal segment was identified by MRI. The time between onset of symptoms and surgical intervention ranged from 2 days to 1 year. 62 segments (36 thoracic, 26 lumbar) were treated in this cohort. The pain score estimated by Visual Analog Scale and activity degree were assessed immediately after operation and at 1-, 6-, and 12-month postoperative follow-up. Preoperative and postoperative anterior, midline vertebral heights in fractured vertebrae were measured on lateral radiographs to evaluate the effect of the procedure.

RESULTSThe method achieved a swift pain relief associated with an evidently increased weight-bearing ability. The pain score was reduced from 8.2 to 2.4 points. The anterior and midline vertebral heights in 62 fractured vertebral bodies increased up to 82.76%+/-26.84%, 88.82%+/-21.75% and the wedge decreased from 15 to 8 degrees. This effect persisted at least over a period of two years. The procedure did not induce narrowing of the spinal canal and no severe complications occurred.

CONCLUSIONSBalloon kyphoplasty can result in immediate clinical improvement of mobility and pain relief, increase vertebral body height, and quickly return patient's activity. The short-term results are approved excellent, and the long-term results need further judgment.

Aged ; Aged, 80 and over ; Female ; Humans ; Lumbar Vertebrae ; diagnostic imaging ; injuries ; surgery ; Male ; Middle Aged ; Osteoporosis ; complications ; diagnostic imaging ; Pain Measurement ; Radiography ; Spinal Fractures ; diagnostic imaging ; etiology ; surgery ; Thoracic Vertebrae ; diagnostic imaging ; injuries ; surgery ; Treatment Outcome

BACKGROUNDColles' fracture usually associated with osteoporosis is regarded as the predictor of subsequent osteoporotic fracture. However, it is not clear how the local changes of bone mass take place during the course of treatment and whether the changes are related to clinical practice. The objective of the current study was to investigate the local changes of bone mass in patients with Colles' fracture and their possible clinical relevance in a follow-up study.

METHODSThe radiograms of the second metacarpal in 64 patients with Colles' fracture were assessed for bone density immediately after fracture, 6 weeks, 6 months and 1 year after fracture, respectively. Functional results were evaluated at one year.

RESULTSBone mass six weeks after Colles' fracture was significantly decreased without returning to normal at one year though increased bone mass had been identified 6 months after fracture (P < 0.05), (P < 0.01). At one year significant (P < 0.05) or highly significant (P < 0.01) correlations were observed between bone mass indices of metacarpal and functional results, indicating that poor function is associated with lower bone density. Significant differences (P < 0.05) between fracture patterns also suggested that patients with more severe fractures have a more pronounced bone loss.

CONCLUSIONSBone loss during the course of treatment will have a direct effect upon the prognosis, so different treatment should be proposed for different patterns of fractures. Active exercise should be made to improve the recovery of bone mass.

Adult ; Aged ; Bone Density ; Colles' Fracture ; complications ; diagnostic imaging ; Female ; Follow-Up Studies ; Humans ; Male ; Metacarpus ; diagnostic imaging ; Middle Aged ; Osteoporosis ; etiology ; Radiography

OBJECTIVETo explore the clinical value of 64-slice spiral CT for spinal structure assessment in elderly patients with osteoporosis.

METHODSThe computed radiography (CR) films and 64-slice spiral CT isotropic scanning images of 40 patients who had been diagnosed as osteoporosis by dual-energy X-ray absorptiometry (DXA) were retrospectively analyzed. The patients were divided into two groups according to their T-scores by DXA: group A (T-score was -1.0 - (-2.5)); and B group (T-score was below -2.5).

RESULTSThe diagnostic results of axial CT images combined with multi-planar reconstruction (MPR) was negatively correlated with the measurement results of DXA in the diagnosis of spinal osteoporosis, and such correlation was higher in group B than in group A. Compared with CR films, axial CT images combining with MPR showed superior effectiveness in the diagnosis of osteoporosis.

CONCLUSIONS64-slice spiral CT is better than CR in diagnosis of osteoporosis. CT-MPR and 3D reconstruction not only can be used to diagnose osteoporosis early, but also to observe the changes of skeleton's shape and overall structure.

Aged ; Female ; Humans ; Image Processing, Computer-Assisted ; methods ; Lumbar Vertebrae ; diagnostic imaging ; pathology ; Male ; Middle Aged ; Osteoporosis ; diagnostic imaging ; Retrospective Studies ; Tomography, Spiral Computed

For the purpose of identifying the effect of body mass index on bone mineral density, an investigation was made in regard to the relationship between body mass index (BMI), bone mineral density (BMD) and bone mineral content (BMC) of lumbar vertebrals of men without osteoporosis. 838 male patients were diagnosed and treated in West China Hospital of Sichuan University because of ostealgia and arthralgia from Aug. 2003 to Dec. 2005. They were examined by dual-energy X-ray absorptiometry, their L2-L4 bone mineral density being < -2.5SD. Then they were graded by body mass index (Kg/m2) [1st group BMI > or =23, 454 cases (Group A BMI > or = 29, 46 cases; Group B 25 < or = BMI < 28.9, 201 cases; Group C 23 < or = BMI < 24, 9193 cases); 2nd group 18.5 < BMI < 22.9, 311 cases; 3rd group BMI < or = 18.5, 68 cases]. The relationships between BMI and BMD of lumbar spine were analyzed using SPSS 13.0. The results revealed their positions in series: (1) Among Groups 1-3, BMD, average BMD and aBMC of L2-L4 being 3rd group > 2nd group > 1st group, the differencs are statistically significant (P < 0.05 or P < 0.01); BMC, aBMC of L3 and L4 and aBMC of L2 being 3rd group > 2nd group > 2nd group, the differences are significant (P < 0.01); besides BMC of L2 and T-score,the differencs among three groups are not statistically significant (P > 0.05); (2) Among the 1st group, BMD and average BMD of L2-L4 being Group C > Group B > Group A,the differencs are significant (P < 0.05 or P < 0.01); BMC, aBMC of L and I being Group C > Group B > Group A,the differences among the three groups are significant (P < 0.05 or P < 0.01); BMC, aBMC of L3 and L4 and aBMC of L2 being Group C > Group B > Group A, the differences are significant, besides BMC of L2 and T-score,the differences among three groups are not significant (P > 0.05), (3) BMI correlated negatively (P < 0.01, r = -0.189) to the average BMD of lumbar spine. The average BMD of lumbar spine decreases when BMI increases in males without osteoporosis. When obesity is more obvious, the decrease in average BMD of lumbar spine bone is more evidently decreased. The decrease of BMD, BMC and total BMC in L3 and L may be greater than that in L2.
Absorptiometry, Photon ; Aged ; Arthralgia ; diagnostic imaging ; metabolism ; Body Composition ; physiology ; Body Mass Index ; Bone Density ; Humans ; Lumbar Vertebrae ; diagnostic imaging ; metabolism ; Male ; Middle Aged ; Osteoporosis