高分辨率CT图像定量描述非胰岛素治疗2型糖尿病患者跟骨形态学改变  

High resolution computerized tomography of calcaneus bone in type 2 diabetes patients following non-insulin therapy: A morphological study

作　　者：胡彦君[1] 王峻[1] 甄俊平[1] 唐笑先[2] 范智斌[3] 

机构地区：[1]山西医科大学第二医院影像科,山西省太原市030001 [2]山西省人民医院影像科,山西省太原市030001 [3]山西煤炭中心医院,山西省太原市030001

出　　处：《中国组织工程研究与临床康复》2008年第26期5071-5074,共4页Journal of Clinical Rehabilitative Tissue Engineering Research

摘　　要：背景：近年来,骨代谢疾病趋向于骨组织形态学研究,CT技术特别是高分辨CT的发展使非创伤性检查骨微观形态成为可能。目的：评估高分辨CT所获骨结构参数在研究非胰岛素治疗2型糖尿病患者跟骨微细结构形态学中的作用。设计、时间及地点：对比观察,于2006-10/2007-10在山西医科大学第二医院内分泌科进行。对象：选择临床确诊为2型糖尿病且未接受胰岛素治疗患者16例作为病例组,均为男性,年龄50-60岁,平均（54.00±1.75）岁;身高（170.87±2.87）cm;体质量（70.06±4.69）kg。同期选择健康志愿者16例为对照组,均为男性,平均年龄（54.25±1.77）岁;身高（170.06±3.53）cm;体质量（68.31±6.19）kg。方法：两组均经64层螺旋CT扫描获取高分辨CT图像进行分析及双能X射线骨密度仪检查。避开周围皮质,在应力骨小梁后组区及中央三角区,各选定一矩形感兴趣区,所有测量均在感兴趣区中进行。主要观察指标：骨小梁各项表观结构参数。结果：病例组中央三角区的骨小梁面积/感兴趣区面积低于对照组、病例组骨髓面积/感兴趣区面积高于对照组,差异有显著性意义（P〈0.05）;应力性骨小梁后组表观结构参数两组比较差异无显著性意义（P〉0.05）。中央三角区骨小梁表观结构参数骨小梁面积/感兴趣区面积与骨密度呈正相关、骨髓面积/感兴趣区面积、单位面积欧拉数与骨密度呈负相关。结论：跟骨高分辨CT图像能客观反映糖尿病非胰岛素治疗患者跟骨微观形态学方面的改变。BACKGROUND： Morphology becomes a focus in study of metabolic bone disease recently. CT technique development, especially high resolution computerized tomography （HRCT） enables micromorphology using noninvasive method. OBJECTIVE： To evaluate roles of calcaneus structural parameters obtained by HRCT in the morphological study of patients with type 2 diabetes without insulin therapy. DESIGN, TIME AND SETTING： Controlled observation was performed at Department of Endocrinology of Shanxi Medical University Second Hospital from October 2006 to October 2007. PARTICIPANTS： Sixteen male patients with type 2 diabetes mellitus without insulin therapy, aged （54.00± 1.75） years （rang 50-60 years）, weighing （70.06±4.69） kg, （170.87±2.87） cm were selected as diabetic group. In addition, 16 healthy male volunteers, aged （54.25 ± 1.77） years, （170.06±3.53） cm, weighing （68.31 ± 6.19） kg, were selected as controls. METHODS： The two groups were tested by dual-energy X-ray absorptiometry （dual-energy X-ray absorptiometry, DXA） and 64-slice spiral CT scans to obtain HRCT image for analysis. Avoiding cortical bone, rectangle region of interesting （ROI） was selected in posterior part of stress trabecular area and the central triangle, respectively. All measurements were performed in the regions of interesting. MAIN OUTCOME MEASURES： Trabecular structural parameters. RESULTS： Ratio of trabecular partition to ROI area in diabetic group was significantly lower than the control group, while ratio of bone marrow partition to ROI area was significantly higher than the control group （P 〈 0.05）. There were no significant differences in trabecular structural parameters from posterior part of stress trabecular area between two groups （P 〉 0.05）. There is positive correlation between bone mineral density and ratio of trabecular partition to ROI area, and negative correlation between bone marrow partition to ROI area or Euler number. CONCLUSION： HRCT image analysis is valuab

关 键 词：骨小梁表观参数 骨密度 糖尿病性骨质疏松 DXA HRCT 活体形态学 

分 类 号：R681.4[医药卫生—骨科学]