骨质疏松老年妇女腰椎有限元分析对骨强度的评价  

Evaluation of finite element analysis of lumbar vertebral strength in elderly women with osteoporosis

作　　者：吴胜勇[1] 张美超[2] 李景学[3] 欧阳钧[2] 温连庆[1] 祁吉[1] 

机构地区：[1]天津医科大学附属第一中心医院放射科,300192 [2]南方医科大学解剖学教研室 [3]天津医科大学总医院放射科

出　　处：《中国骨质疏松杂志》2005年第3期292-294,291,共4页Chinese Journal of Osteoporosis

摘　　要：目的应用骨质疏松老年妇女腰椎L1椎体MSCT扫描像建立的有限元(FE)模型,比较骨质疏松性椎体骨折和无椎体骨折老年妇女腰椎骨强度的变化情况。方法对来我院行DXA(GElunarDPX)检查并诊断为骨质疏松的老年妇女中分别随机选取骨质疏松性椎体骨折和无骨折妇女各5例患者进行腰椎L1及L2水平多层螺旋CT(MSCT,GELightspeed型)扫描,并行vQCT测量。将原始数据回顾性重建时形成层厚为0.625mm的横断面影像,经ANSYS7.0软件在FE模型中,观察在生理载荷条件下椎体中部皮质骨边缘的应力分布及应变数值,计算椎体内应变≥5000μstrain的小梁骨体积占骨小梁总体积比率。结果骨质疏松性椎体骨折老年妇女椎体中部前缘以及同水平左、右侧部应变在的平均值分别为0.035strain、0.078strain和0.086strain,相对于无骨折妇女数值0.027strain、0.057strain和0.065strain有增高的趋势。5例骨质疏松性椎体骨折老年妇女椎体内具骨折危险性小梁骨体积占骨小梁总体积的比率平均为19.2%±0.9%,高于5例无椎体骨折老年妇女平均值16.1%±1.0%(P<0.01)。结论骨质疏松性椎体骨折老年妇女FE分析中椎体内具骨折危险性小梁骨体积占骨小梁总体积的比率高于无椎体骨折老年妇女,对骨质疏松病人在体评价骨强度具有重要的临床应用价值。Objective To compare the bone strength between osteoporotic vertebral fracture and nonfractured vertebra in elderly women with finite element （FE） model established by MSCT scanning of L1 in osteoporotic elderly women. Methods Ten elderly women, 5 with osteoporotic fracture and 5 without, were randomly selected among osteoporotic patients examined by DXA（ GE-Lunar DPX）. Comparision was made of changes of stress strain after the physiological compressive, and the index of trabecular volume to total volume with compress strains above 5000 μstrain,in FE model （ANSYS 7.0 software） of L1 scanned with multi-slice CT（MSCT, GE LightSpeed 16）. Results By FE analysis, strain level at front margin and bilateral sites of middle cortical bone in 5 fractured women （0.035 strain,0.078 strain and 0.086 strain） had increasing trend comparing to the 5 non-fractured women （0.027 strain ,0.057 strain and 0.065 strain）, and the former group＇s percentage of the material with compressive strains above 5000 μstrain was 19.2% ±0.9%, significantly higher than higher than later group 16.1% ± 1.0%（P 〈0.01）. Conclusions The trabecular volume where at risk of fracture were higher in osteopototic fractured group than that in non-fractured group. FEA will have important clinical value in the in vivo evaluation of bone strength of osteoporotic patients.

关 键 词：骨质疏松 骨密度 骨强度 腰椎 多层螺旋CT 生物力学 有限元分析 骨质疏松性椎体骨折 老年妇女 有限元分析 骨强度 腰椎 MSCT扫描 骨折危险性 临床应用价值 椎体中部 

分 类 号：R681.4[医药卫生—骨科学] R713[医药卫生—外科学]