松质骨显微结构参数与表观力学强度关系研究进展

通过双能X射线吸收法测量受试者的骨密度，是目前公认的诊断骨质疏松症的方法。然而，越来越多的基础和临床研究发现，骨密度的改变并不能完全解释患者骨强度的改变。大量的骨组织显微结构研究发现，松质骨的骨强度主要由骨密度、骨结构等因素决定。近年来的研究表明，在决定松质骨骨骼强度方面，骨组织的显微结构可以作为独立于骨密度之外的决定性参数。研究松质骨的力学属性和显微结构之间的关系，对于更好的理解骨质疏松的发生和对骨质疏松的诊断具有十分重要的意义。根据文献回顾，松质骨显微结构参数和表观力学强度之间关联性最为显著的为BV／TV、Tb．N、连接性、各向异性、结构模型指数等。同时笔者也对目前这些研究结果在临床上高分辨率CT上的应用情况做一总结。

Research progress in the relationship between microarchitecture indexes and bone strength of the cancellous bone

Bone mineral density ( BMD) measurement using dual energy X-ray absorptiometry ( DXA) has been widely accepted as a clinical method to diagnose osteoporosis.However, more and more basic and clinical studies have indicated that the variance of cancellous bone strength cannot be fully attributed to the reduction of BMD.Many experiments about microarchitecture of cancellous bone have revealed that cancellous bone strength is determined by BMD, bone architecture and other parameters. The microarchitecture of the bone is a decisive parameter independent of BMD.It is important to study the relationship between microarchitecture and bone strength of cancellous bone in order to understand the development and diagnosis of osteoporosis.Based on literature review, we summarize that the most related parameters between microarchitecture and bone strength are BV/TV, Tb. N, connectivity, degree of Anisotropy, and structure model index.Meanwhile, the clinical application of the research results on high resolution CT is also summarized.