核磁共振骨皮质成像关键技术研究进展

包尚联; 杜江; 高嵩

doi:10.7498/aps.62.088701

摘要

骨质量尤其是骨皮质质量的评价方法对骨病的诊断和治疗有重要意义. 随着社会快速老龄化, 如何非侵入地获得准确实用的骨质量评价指标已成为医学物理领域亟待解决的热点问题. 目前有多种骨质量评价方法, 其中双能X射线吸收法获得的骨矿密度值是评价骨质量的现行金标准, 但这个参数有明显缺陷, 如不能反映骨皮质中的有机基质、微结构、孔隙度及灌注等情况, 所以不能准确诊断骨质疏松和预测骨折等疾病. 由于骨的磁共振信号衰减极快,所以常规磁共振成像技术不能探测到骨的信号. 近年来随着理论、方法和设备的不断进步, 超短回波磁共振骨成像成为可能. 本文简要介绍超短回波磁共振骨成像的基础物理理论, 结合作者所在实验室的研究工作对各类定性及定量超短回波磁共振骨皮质成像新方法进行综述, 总结各类方法的特点、适用范围及不足, 指出进一步研究的方向、重点及步骤, 对超短回波磁共振成像在骨质量评估方面的理论研究及工程应用具有指导意义.

关键词:

Abstract

The evaluation of bone quality, especially cortical bone, is very important for diagnosing and treating the bone diseases. Because of the rapidly aging population of the global society, noninvasively, precisely and feasibly evaluating the bone quality has become a hot topic in the contemporary medical physics studies. Among the several available methods of evaluation, the bone mineral density (BMD) measured with dual-energy X-ray absorptiometry is currently considered to be the gold standard in clinical applications. However, the BMD is limited by its incapability of assessing the organic matrix, microstructure, porosity and perfusion of bone. In addition, the BMD can neither provide a definite diagnose of osteoporosis nor predict fractures precisely. Cortical bone shows near zero signal with all conventional clinical magnetic resonance imaging (MRI) sequences, because of the rapid decay of the magnetic resonance signal in the bone. Due to the recently developed theories, methods and hardware, ultrashort time echo (UTE) sequences with nominal TE of less than 100 s have aroused the increasing research interest. In this paper an introduction to the basic physics of UTE MRI of cortical bone is presented. The newly proposed qualitative and quantitative UTE MRI methods are reviewed with an introduction to the research work in the authors laboratory. The features, application scopes and limitations of those methods are also summarized. Finally, the authors point out the directions and steps of further studies. The paper will be helpful for understanding theoretical research and the clinical applications of UTE imaging of cortical bone.

Keywords:

作者及机构信息

1.
北京大学物理学院, 医学物理和工程北京市重点实验室, 北京 100871;

2.
美国加利福尼亚大学圣迭哥分校放射学系, 美国圣迭哥 CA 92103-8226;

3.
北京大学医学部医学影像物理实验室, 北京 100191

基金项目: 国家自然科学基金(批准号:81171330)、国家重点基础研究发展计划 (批准号:2011CB707701)和北京市自然科学基金(批准号:7102102)资助的课题.

Authors and contacts

1.
Beijing Key Laboratory of Medical Physics and Engineering, School of Physics, Peking University, Beijing 100871, China;

2.
Department of Radiology, University of California, San Diego, CA 92103-8226, USA;

3.
Medical Imaging Physics Laboratory, HSC of Peking University, Beijing 100191, China

Funds: Project supported by the National Natural Science Foundation of China (Grant No. 81171330), the National Basic Research Program of China (Grant No. 2011CB707701), and the Natural Science Foundation of Beijing, China (Grant No. 7102102).

参考文献

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[22]	Techawiboonwong A, Song H K, Leonard M B, Wehrli F W 2008 Radiology 238 824
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[26]	Du J, Diaz E, Carl M, Bae W, Chung C, Bydder G M 2012 Magn. Reson. Med. 67 645
[27]	Diaz E, Chung C B, Bae W C, Statum S, Znamirowski R, Bydder G M, Du J 2012 NMR in Biomed. 25 161
[28]	Raya J G, Dietrich O, Horng A, Weber J, Reiser M F, Glaser C 2010 Magn. Reson. Med. 63 181
[29]	Horch R A, Nyman J S, Gochberg D F, Dortch R D 2010 Magn. Reson. Med. 64 680
[30]	Wehrli F W, Song H K, Saha P K, Wright A C 2006 NMR Biomed. 19 731
[31]	Wehrli F W, Fernandez-Seara M A 2005 Ann. Biomed. Eng. 33 79
[32]	Techawiboonwong A, Song H K, Wehrli F W 2008 NMR in Biomed. 21 59
[33]	Ramani A, Dalton C, Miller D H, Tofts P S, Barker G J 2002 Magn. Reson. Imaging 20 721
[34]	Henkelman R M, Stanisz G J, Graham S J 2001 NMR in Biomed. 14 57
[35]	Yu Y, Jiang Q, Miao Y, Li J, Bao S L, Wang H Y, Wu C, Wang X, Zhu J, Zhong Y, Haacke E M 2010 Radiology 257 47
[36]	Wang H, Miao Y, Zhou K, Yu Y M, Bao S L, He Q, Dai Y, Xuan S Y, Tarabishy B, Ye Y, Hu J N 2010 Med. Phys. 37 4971
[37]	Girard O, Du J, Bydder G M, Mattrey R 2011 Proceedings of the 19th Annual Meeting of ISMRM Montreal, Canada May 7-13, 2011 p3210
[38]	Tofts P 1997 J. Magn. Reson. Imag. 7 91
[39]	Wang H Z, Xu L F, Yu J, Huang Q M, Wang X Y, Lu L, Wang H, Huang Y, Cheng H Y, Zhang X L, Li G Y 2010 Acta Phys. Sin. 59 7463 (in Chinese) [汪红志, 许凌峰, 俞捷, 黄清明, 王晓琰, 陆伦, 王鹤, 黄勇, 程红岩, 张学龙, 李鲠颖 2010 物理学报 59 7463]
[40]	Bao S L 2004 Modernization Medical Physics (1st Ed.) (Beijing:Peking University Medical Press) p728 (in Chinese)[包尚联 2004现代医学影像物理学(第一版) (北京：北京大学医学出版社) 第728页]
[41]	Bao S L, Gao S 2013 Progress of Modernization Medical Physics (1st Ed.) (Beijing:Peking University Press) (in Chinese) [包尚联, 高嵩 2013 现代医学影像物理学进展(第一版) (北京：北京大学出版社)] (in press)
[42]	Zhang G Q, Du X J, Zhao L, Ning F P, Yao W C, Zhu Z A 2012 Acta Phys. Sin. 61 228701 (in Chinese) [张国庆, 杜晓纪, 赵玲, 宁飞鹏, 姚卫超, 朱自安 2012 物理学报 61 228701]

施引文献

[1]	Bao S L, Zhou C N, Guo Z G 2010 Biology Fundamental Theory of Medical Imaging (1st Ed.) (Beijing:Higher Education Press) p99 (in Chinese) [包尚联, 周传农, 郭占国 2010 医学影像生物学基础(第1版) (北京:高等教育出版社)第99页]
[2]	Faulkner K G 2000 J. Bone Miner. Res. 15 183
[3]	Schuit S C, Klift M, Weel A E, Laet C E, Burger H, Seeman E, Hofman A, Uitterlinder A G, Leeuwen J P, Pols H A 2004 Bone 34 195
[4]	Cummings S R, Karpf D B, Harris F, Genant H K, Ensrud K, LaCroix A Z, Black D M 2002 Am. J. Med. 112 221
[5]	Bousson V, Meunier A, Bergot C, Vicaut E, Rocha M A, Morais M H, Laval-Jeantet A M, Laredo J D 2001 J. Bone Miner. Res. 16 1308
[6]	Burghardt A J, Kazakia G J, Ramachandran S, Link T M, Majumdar S 2010 J. Bone Miner. Res. 25 983
[7]	Diab T, Vashishth D 2005 Bone 37 96
[8]	Josan S, Pauly J M, Daniel B L, Pauly K B 2009 Magn. Reson. Med. 61 1083
[9]	Robson M D, Gatehouse P D, Bydder M, Bydder G M 2003 J. Comput. Assist. Tomogra. 27 825
[10]	Du J, Bydder M, Takahashi A M, Carl M, Chung C B, Bydder G M 2011 Magn. Reson. Imag. 29 470
[11]	Du J, Carl M, Bydder M, Takahashi A, Chung C B, Bydder G M 2010 J. Magn. Reson. 207 304
[12]	Du J, Takahashi A M, Bae W C, Chung C B, Bydder G M 2010 Magn. Reson. Med. 63 447
[13]	Du J, Takahashi A M, Bydder M, Chung C B, Bydder G M 2009 Magn. Reson. Med. 62 527
[14]	Horch R A, Gochberg D F, Nyman J S, Does M D 2011 PLoS ONE 6 e16359
[15]	Bae W C, Chen P C, Chung C B, Masuda K, D'Lima D, Du J 2012 J. Bone Miner. Res. 27 848
[16]	Wu Y, Hrovat M I, Ackerman J L, Reese T G, Cao H, Ecklund K, Glimcher M J 2010 J. Magn. Reson. Imag. 31 954
[17]	Reichert I L H, Robson M D, Gatehouse P D, He T 2005 Magn. Reson. Imag. 23 611
[18]	Springer F, Martirosian P, Machann J, Schwenzer N F, Claussen C D, Schick F 2009 Magn. Reson. Med. 61 1040
[19]	McCarthy I 2006 J. Bone Joint Surg. 88 4
[20]	Wang Y X, Griffith J F, Kwok A W L, Leung J C S, Yeung D K W, Ahuja A T, Leung P C 2009 Bone 45 711
[21]	Ma H T, Griffith J F, Yeung D K, Leung P C 2010 Proceedings of the 18th Annual Meeting of ISMRM Stockholm, Sweden May 1-7, 2010 p1968
[22]	Techawiboonwong A, Song H K, Leonard M B, Wehrli F W 2008 Radiology 238 824
[23]	Lu A, Daniel B L, Pauly J M, Pauly K B 2008 J. Magn. Reson. Imag. 28 190
[24]	Biswas R, Bae W, Diaz E, Masuda K, Chung C, Bydder G M, Du J 2012 Bone 50 749
[25]	Anastasiou A, Hall L D 2004 Magn. Reson. Imag. 22 67
[26]	Du J, Diaz E, Carl M, Bae W, Chung C, Bydder G M 2012 Magn. Reson. Med. 67 645
[27]	Diaz E, Chung C B, Bae W C, Statum S, Znamirowski R, Bydder G M, Du J 2012 NMR in Biomed. 25 161
[28]	Raya J G, Dietrich O, Horng A, Weber J, Reiser M F, Glaser C 2010 Magn. Reson. Med. 63 181
[29]	Horch R A, Nyman J S, Gochberg D F, Dortch R D 2010 Magn. Reson. Med. 64 680
[30]	Wehrli F W, Song H K, Saha P K, Wright A C 2006 NMR Biomed. 19 731
[31]	Wehrli F W, Fernandez-Seara M A 2005 Ann. Biomed. Eng. 33 79
[32]	Techawiboonwong A, Song H K, Wehrli F W 2008 NMR in Biomed. 21 59
[33]	Ramani A, Dalton C, Miller D H, Tofts P S, Barker G J 2002 Magn. Reson. Imaging 20 721
[34]	Henkelman R M, Stanisz G J, Graham S J 2001 NMR in Biomed. 14 57
[35]	Yu Y, Jiang Q, Miao Y, Li J, Bao S L, Wang H Y, Wu C, Wang X, Zhu J, Zhong Y, Haacke E M 2010 Radiology 257 47
[36]	Wang H, Miao Y, Zhou K, Yu Y M, Bao S L, He Q, Dai Y, Xuan S Y, Tarabishy B, Ye Y, Hu J N 2010 Med. Phys. 37 4971
[37]	Girard O, Du J, Bydder G M, Mattrey R 2011 Proceedings of the 19th Annual Meeting of ISMRM Montreal, Canada May 7-13, 2011 p3210
[38]	Tofts P 1997 J. Magn. Reson. Imag. 7 91
[39]	Wang H Z, Xu L F, Yu J, Huang Q M, Wang X Y, Lu L, Wang H, Huang Y, Cheng H Y, Zhang X L, Li G Y 2010 Acta Phys. Sin. 59 7463 (in Chinese) [汪红志, 许凌峰, 俞捷, 黄清明, 王晓琰, 陆伦, 王鹤, 黄勇, 程红岩, 张学龙, 李鲠颖 2010 物理学报 59 7463]
[40]	Bao S L 2004 Modernization Medical Physics (1st Ed.) (Beijing:Peking University Medical Press) p728 (in Chinese)[包尚联 2004现代医学影像物理学(第一版) (北京：北京大学医学出版社) 第728页]
[41]	Bao S L, Gao S 2013 Progress of Modernization Medical Physics (1st Ed.) (Beijing:Peking University Press) (in Chinese) [包尚联, 高嵩 2013 现代医学影像物理学进展(第一版) (北京：北京大学出版社)] (in press)
[42]	Zhang G Q, Du X J, Zhao L, Ning F P, Yao W C, Zhu Z A 2012 Acta Phys. Sin. 61 228701 (in Chinese) [张国庆, 杜晓纪, 赵玲, 宁飞鹏, 姚卫超, 朱自安 2012 物理学报 61 228701]

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