Multi-Slice-Computertomographie an der distalen Radiusmetaphyse

We explore the relationship of region-specific densitometric and
geometry-based (cortical) parameters at the distal radial
metaphysis with gender, age, and osteoporotic status, using
multislice computed tomography (CT). We specifically test the
hypothesis that these parameters can improve the prediction of
mechanical strength of the distal radius vs bone mass (bone mineral
content [BMC]). The BMC was determined in 56 forearm specimens with
peripheral dual-energy X-ray absorptiometry (DXA). Trabecular and
cortical density and geometric properties of the metaphyseal cortex
were determined using multislice CT and proprietary image analysis
software. Specimens were tested to failure in a fall simulation,
maintaining the integrity of the elbow joint and hand. Women
displayed significantly lower failure strength (-34%), BMC (-35%),
trabecular density (-26%), and cortical area (-12%) than men. The
reduction of trabecular density with age and osteoporotic status
was stronger than that of cortical density or thickness. DXA
explained approx 50% (r2) of the variability in bone failure loads.
This proportion was slightly increased (55%) when adding
geometry-based parameters. The study suggests that high-resolution
tomographic measurements with current clinical imaging methodology
can marginally improve the prediction of mechanical failure
strength. Further efforts are required to improve spatial
resolution for determining metaphyseal cortical properties
clinically.