Bone loss and steady state after spinal cord injury: a cross-sectional study using pQCT.
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Biomedical subjects
Publications and source records attributed to J Willnecker.
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OBJECTIVE: To compare the in situ precision of peripheral quantitative CT (pQCT) at the radius, tibia and femur, and to analyze the intersite correlation, in order to determine whether measurements at the lower extremity reproduce results at the radius or are of additional informative value. DESIGN AND MATERIAL: pQCT measurements were performed in 86 elderly cadavers (mean age 80.5 years) at trabecular and cortical locations in the radius, tibia and femur, determining densitometric (bone mineral content and density) as well as geometric parameters (cross-sectional area, cortical thickness, polar moment of inertia and others). In 14 cadavers, repeated measurements were obtained at all sites on four different days. RESULTS AND CONCLUSIONS: At cortical sites, the precision for the densitometric and geometric variables ranged from 0.4% to 4.3%, and was similar for the radius, tibia and femur. At trabecular locations, the reproducibility of the density measurements ranged from 1.8% to 2.5% at the radius, and from 3.2% to 5.9% at the femur and tibia. The intersite correlation of the total bone mineral content ranged from 0.87 and 0.97 at cortical sites, and from 0.63 to 0.85 at trabecular locations. The trabecular density showed a higher similarity between the tibia and femur (r=0.68-0.78) than between the radius and the lower extremity (r=0.41-0.45). The results demonstrate a substantial heterogeneity of trabecular bone in elderly individuals and advocate measurements directly at the site of clinical or scientific interest.
The aim of the study was to evaluate the accuracy of an XCT 960 Stratec peripheral quantitative computed tomography (pQCT) device in assessing bone mineral content of the radius. We scanned 27 left forearm specimens excised from cadavers and focused on cortical bone mineral content (BMCc) at the junction of the middle and distal third and on total bone mineral content (BMCtot) at the distal end of the radius. Cylindrical specimens matched with those two sites were cut using a diamond circular saw, embedded in a polyester resin and subsequently submitted to two reference methods, nondestructive neutron activation analysis and flame atomic absorption spectrometry. Mineral contents measured by pQCT were closely correlated with those assessed by using the two reference methods, with correlation coefficients ranging from 0.862 to 0.960. The standard error of the estimate amounted 7-10% for the BMCc (junction of the middle and distal third), and 17-18% for the BMCtot (distal end). We conclude that pQCT is able to measure either cortical or total mineral content of the radius with a high degree of accuracy.
The purpose of the present study was to evaluate the accuracy of peripheral quantitative computed tomography (pQCT) in measuring the thickness of the radial cortex. Thirty left forearm specimens were scanned on an XCT 960 Stratec pQCT device using a 2.5 mm thick slice at the junction of the middle and the distal third of the radius. Cortical and trabecular areas were assessed using a threshold procedure; cortical thickness was subsequently calculated assuming a circular ring model for the radius. Cortical thickness was also measured on the true shape of bone using an iterative contour detection procedure. Subsequently 2.5 mm thick resin-embedded cylindrical radial specimens, matched with the site of pQCT examination, were obtained and contact radiographs were performed. After tenfold magnification, the cortical and trabecular areas of the specimens were measured using computerized planimetry and cortical thickness was calculated assuming a circular ring model. The cortical thickness could be assessed by pQCT in all cases using the threshold algorithm (mean (SD) 2.51 (0.58) mm) and in 21 cases could be directly measured on the true shape of bone (2.62 (0.32) mm). The cortical thickness of the specimens showed good correlation and high proportionality with that measured using pQCT with either the threshold algorithm (r = 0.941, slope = 0.976) or the iterative contour detection procedure (r = 0.883, slope = 0.987). In conclusion, pQCT is able to assess the thickness of the radial cortex, at the junction of the middle and the distal third, with high accuracy.
Our aim was to evaluate the role of cortical bone in resistance to compression in the human radius. Thirty-three left cadaver forearms were scanned on an XCT 960 Stratec CT scanner. Cortical density and cortical thickness were measured at the junction of the middle and distal third of the radius. Subsequently, 2-cm-high cylindrical specimens, centrated on the level of the CT slice, were cut. After removal of the endosteal trabecular bone, the specimens were submitted to compressive testing, using an Instron machine, and load deformation curves were obtained. Maximal stress (load corrected for cross-sectional area) showed a significant relationship with the density (r = 0.78) as well as with the thickness (r = 0.74) of the cortex. The closest correlation involved the maximal load and the mineral content of the cortex specimens (r = 0.87). We conclude that the mineral content of these radius cortex specimens, measured using peripheral QCT, predicts their compressive strength on biomechanical testing.
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