基于Micro-CT对60~80岁老年人股骨近端骨微结构的三维数字化测量  

Three⁃dimensional digital measurement of proximal femoral bone microstructure in 60⁃80 years old patients based on Micro⁃CT

作　　者：陈荟如 吕涛 左超 包艳艳 胡艺涵 王建忠 金凤[3] 张云凤[4] 王海燕 李筱贺 CHEN Hui-ru;LÜTao;ZUO Chao;BAO Yan-yan;HU Yi-han;WANG Jian-zhong;JIN Feng;ZHANG Yun-feng;WANG Hai-yan;LI Xiao-he(Tongliao Clinical Medical College of Inner Mongolia Medical University,Inner Mongolia Tongliao 028007,China;Department of Human Anatomy,Basic Medical College,Inner Mongolia Medical University,Inner Mongolia Autonomous Region Digital Translational Medicine Engineering Technology Research Center,Hohht 010110,China;Department of Imaging,Affiliated Hospital of Inner Mongolia Medical University,Hohht 010059,China;Imaging Department,the Second Affiliated Hospital of Inner Mongolia Medical University,Hohht 010110,China)

机构地区：[1]内蒙古医科大学通辽临床医学院,内蒙古通辽028007 [2]内蒙古医科大学基础医学院人体解剖学教研室,内蒙古自治区数字转化医学工程技术研究中心,呼和浩特010110 [3]内蒙古医科大学附属医院影像科,呼和浩特010059 [4]内蒙古医科大学第二附属医院影像科,呼和浩特010110

出　　处：《解剖学报》2025年第1期88-94,共7页Acta Anatomica Sinica

基　　金：内蒙古自治区2023年自治区重点研发和成果转化计划(科技支撑黄河流域生态保护和高质量发展)项目(2023YFHH0003);2021年内蒙古自治区蒙医药协同创新中心科学研究项目(MYYXTYB202104);内蒙古自治区教育厅高等学校创新团队发展计划(NMGIRT2227);内蒙古医科大学2021年度校级科研重点项目(YKD2021ZD001);内蒙古医科大学大学生科技创新“英才培育”项目(内医团发[2021]22号YCPY2022036)。

摘　　要：目的探讨老年人群股骨近端不同区域骨质微观结构特点,为假体的设计改良及分析结构特征提供解剖学参考。方法选取内蒙古医科大学人体解剖学微计算机断层扫描实验室60~80岁完整尸体,共获得30例完整股骨近端骨标本,利用微计算机断层扫描(Micro-CT)仪,并使用自带分析测量软件测量股骨头近端压力骨小梁(PPT)、远端压力骨小梁(DPT)、股骨颈头下部(FHNJ)、股骨颈头颈部(HNFN)、股骨颈基底部(BPFN)、转子间线(IL)和大转子(GT)7个区域骨小梁厚度、骨小梁数量、骨小梁间隙、骨密度和连通性等参数。结果骨密度:IL和GT的数值均大于BPFN、FHNJ、DPT、PPT。骨小梁厚度:GT的数值最大,IL、BPFN、HNFN 3个部位次之,FHNJ、DPT、PPT 3个部位最小。骨小梁间隙:IL的数值大于GT,两者数据均大于其余部位,其中DPT和PPT最小。骨小梁数量:IL和GT数值最小,BPFN、HNFN、FHNJ较大,DPT最大。体积分数:IL的数值最小,BPFN、HNFN较大,DPT和PPT最大。结论老年股骨近端GT及IL骨密度、骨小梁厚度、骨体积和总体积均较大,好发骨折的原因并非内在骨微结构存在薄弱;垂直骨小梁近端及远端骨密度、骨小梁厚度及骨小梁间隙较小,如需进行髓芯减压做假体填充,设计时要有利于填充假体的力学传导和周围骨组织的再生。Objective To observe the difference of bone micro⁃structure in different regions of proximal femur,micro⁃CT scanning was performed on 30 proximal femur specimens to explain the mechanism of proximal femur fracture and to provide anatomical basis for prosthesis design.Methods Totally 30 intact proximal femur specimens were obtained from 60⁃80 year⁃old cadavers.Micro⁃CT scanning was used to measure the trabecular thickness(Tb.Th),trabecular number(Tb.N),trabecular space(Tb.Sp),connectivity(Conn)and bone mineral density(BMD)and other parameters in 7 regions of proximal femur,including proximal pressure trabecular(PPT),distal pressure trabecular(DPT),femoral head⁃neck junction(FHNJ),head and neck of femoral neck(HNFN),the base of femoral neck(BPFN),intertrochanteric line(IL)and greater trochanter(GT).Results The bone mineral density of IL and GT were higher than those of BPFN,FHNJ,DPT and PPT.The trabecular thickness of GT was the largest,followed by IL,BPFN and HNFN,and the smallest was FHNJ,DPT and PPT.The trabecular space of IL was larger than that of GT,and the data of both were larger than those of other parts,among which DPT and PPT were the smallest.The trabecular number of IL and GT were the smallest,BPFN,HNFN and FHNJ were larger,and DPT was the largest.The volume fraction of IL was the smallest,BPFN and HNFN were larger,DPT and PPT were the largest.Conclusion The bone density,trabecular thickness,bone volume,and total volume of GT and IL in the proximal femur of elderly patients are all relatively large,so the reason for the high incidence of fractures is not due to weak internal bone microstructure;The bone density,trabecular thickness,and trabecular gap at the proximal and distal ends of the vertical trabecular bone are relatively small.If it is necessary to perform core decompression for prosthesis filling at this location,the design should be conducive to the mechanical conduction of the prosthesis and the regeneration of surrounding bone tissue.

关 键 词：松质骨 骨微结构 解剖学 微计算机断层扫描 老年人 

分 类 号：R3[医药卫生—基础医学]