[Analysis of correlation between trabecular microstructure and clinical imaging parameters in fracture region of osteoporotic hip]

Jing Peng, Yong Zhou, Li Min, Wenli Zhang, Yi Luo, Xuelei Zhang, Chang Zou, Rui Shi, Chongqi Tu
Chinese Journal of Reparative and Reconstructive Surgery 2014, 28 (5): 576-80

OBJECTIVE: To analyze the correlation between the trabecular microstructure and the clinical imaging parameters in the fracture region of osteoporotic hip so as to provide a simple method to evaluate the trabecular microstructure by a non-invasive way.

METHODS: Between June 2012 and January 2013, 16 elderly patients with femoral neck fracture underwent hip arthroplasty were selected as the trial group; 5 young patients with pelvic fracture were selected as the control group. The hip CT examination was done, and cancellous bone volume/marrow cavity volume (CV/MV) was analyzed with Mimics 10.01 software in the control group. The CT scan and bone mineral density (BMD) measurement were performed on normal hips of the trial group, and cuboid specimens were gained from the femoral necks at the place of the tensional trabeculae to evaluate the trabecular microstructure parameters by Micro-CT, including bone volume fraction (BV/TV), trabecular number (Tb.N), trabecular spacing (Tb.Sp), trabecular thickness (Tb.Th), connect density (Conn.D), and structure model index (SMI). The correlation between imaging parameters and microstructure parameters was analyzed.

RESULTS: In the trial group, the BMD value was 0.491-0.698 g/cm2 (mean, 0.601 g/cm2); according to World Health Organization (WHO) standard, 10 cases were diagnosed as having osteoporosis, and 6 cases as having osteopenia. The CV/MV of the trial group (0.670 1 +/- 0.102 0) was significantly lower than that of the control group (0.885 0 +/- 0.089 1) (t = -4.567, P = 0.000). In the trial group, CV/MV had correlation with BV/TV, Tb.Th, and SMI (P < 0.05); however, CV/MV had no correlation with Tb.N, Tb.Sp, or Conn.D (P > 0.05). BV/TV had correlation with Tb.Th, Tb.N, Tb.Sp, and SMI (P < 0.05), but it had no correlation with Conn.D (P=0.075). There was no correlation between BMD and microstructure parameters (P > 0.05).

CONCLUSION: CV/MV obviously decreases in the osteoporotic hip, and there is a correlation between CV/MV and the microstructure parameters of BV/TV, Tb.Th, and SMI, to some extent, which can reflect the variety of the microstructure of the trabeculae. There is no correlation between BMD of femoral neck and microstructure parameters.

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