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首页> 外文期刊>BMC Musculoskeletal Disorders >A customized protocol to assess bone quality in the metacarpal head, metacarpal shaft and distal radius: a high resolution peripheral quantitative computed tomography precision study
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A customized protocol to assess bone quality in the metacarpal head, metacarpal shaft and distal radius: a high resolution peripheral quantitative computed tomography precision study

机译：一种定制协议，可评估掌骨头，掌骨干和远端radius骨的骨质量：高分辨率外周定量计算机断层扫描精度研究

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Background High Resolution-Peripheral Quantitative Computed Tomography (HR-pQCT) is an emerging technology for evaluation of bone quality in Rheumatoid Arthritis (RA). However, there are limitations with standard HR-pQCT imaging protocols for examination of regions of bone commonly affected in RA. We developed a customized protocol for evaluation of volumetric bone mineral density (vBMD) and microstructure at the metacarpal head (MH), metacarpal shaft (MS) and ultra-ultra-distal (UUD) radius; three sites commonly affected in RA. The purpose was to evaluate short-term measurement precision for bone density and microstructure at these sites. Methods 12 non-RA participants, individuals likely to have no pre-existing bone damage, consented to participate [8 females, aged 23 to 71 y [median (IQR): 44 (28) y]. The custom protocol includes more comfortable/stable positioning and adapted cortical segmentation and direct transformation analysis methods. Dominant arm MH, MS and UUD radius scans were completed on day one; repeated twice (with repositioning) three to seven days later. Short-term precision for repeated measures was explored using intraclass correlational coefficient (ICC), mean coefficient of variation (CV%), root mean square coefficient of variation (RMSCV%) and least significant change (LSC%95). Results Bone density and microstructure precision was excellent: ICCs varied from 0.88 (MH2 trabecular number) to .99 (MS3 polar moment of inertia); CV% varied from?2 vBMD) to 6 (MS3 marrow space diameter); RMSCV% varied from?2 full bone vBMD) to 7 (MS3 marrow space diameter); and LSC% 95varied from 2 (MS2 full bone vBMD to 21 (MS3 marrow space diameter). Cortical porosity measures were the exception; RMSCV% varying from 19 (MS3) to 42 (UUD). No scans were stopped for discomfort. 5% (5/104) were repeated due to motion during imaging. 8% (8/104) of final images had motion artifact graded?>?3 on 5 point scale. Conclusion In our facility, this custom protocol extends the potential for in vivo HR-pQCT imaging to assess, with high precision, regional differences in bone quality at three sites commonly affected in RA. Our methods are easy to adopt and we recommend other users of HR-pQCT consider this protocol for further evaluations of its precision and feasibility in their imaging facilities.
机译：背景技术高分辨率外周定量计算机断层扫描（HR-pQCT）是一种新兴技术，用于评估类风湿关节炎（RA）的骨质量。但是，标准HR-pQCT成像协议在检查RA中通常受影响的骨骼区域方面存在局限性。我们开发了定制的协议，用于评估掌骨头（MH），掌骨干（MS）和超超远端（UUD）半径处的体积骨矿物质密度（vBMD）和微观结构;在RA中通常受影响的三个地点。目的是评估这些部位的骨密度和显微结构的短期测量精度。方法12名非RA参与者（可能没有先前的骨损伤）同意参加[8名女性，年龄23至71岁[中位数（IQR）：44（28）岁]。定制协议包括更舒适/稳定的定位以及适应的皮质分割和直接转换分析方法。在第一天完成了主要的MH，MS和UUD半径扫描。在三到七天后重复两次（重新定位）。利用类内相关系数（ICC），平均变异系数（CV％），均方根变异系数（RMSCV％）和最小有效变异（LSC％ 95 ）。结果骨密度和显微组织精度均极好：ICCs从0.88（MH 2 骨小梁数）变化到.99（MS 3 极惯性矩）。 CV％从？2 vBMD）变化到6（MS 3 骨髓间隙直径）; RMSCV％从？2 的全骨vBMD变化到7（MS 3 的骨髓间隙直径）;和LSC％ 95 从2（MS 2 全骨vBMD到21（MS 3 骨髓间隙直径））变化。 ; RMSCV％从19（MS 3 ）到42（UUD）不等，没有因不适而停止扫描;由于成像期间的运动而重复进行了5％（5/104）的检查; 8％（8 / 104）的最终图像的运动伪影在5点尺度上分级为？>？3。结论在我们的机构中​​，此定制协议扩展了体内HR-pQCT成像的潜力，可以高精度地评估三个区域的骨质量差异我们的方法易于采用，我们建议HR-pQCT的其他用户考虑使用此协议，以进一步评估其在成像设备中的精度和可行性。

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