Die Vertebral Bone Quality als neuer Parameter zur Einschätzung einer Osteoporose - ein Vergleich mit der quantitativen Computertomographie

The Vertebral Bone Quality as a new parameter for assessing osteoporosis - a comparison with quantitative computertomography

von Bahar Çelik
Dissertation
Datum der mündl. Prüfung:2024-09-03
Erschienen:2024-07-12
Betreuer:PD Dr. Jonathan Roch
Gutachter:PD Dr. Jonathan Roch
Gutachter:PD Dr. Ali Seif Amir Hosseini
Zum Verlinken/Zitieren: http://dx.doi.org/10.53846/goediss-10599

 

 

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Zusammenfassung

Englisch

The diagnosis of osteoporosis is an important element that significantly influences the surgical and conservative treatment of patients because affected bones are very susceptible to fractures and subsequent complications. According to the DVO guidelines, bone density is currently determined using dual X-ray absorptiometry (DXA). This investigation but is not performed as standard on every preoperative patient. As an alternative to the classic DXA examination, quantitative computed tomography (qCT) has been developed in recent years and can be used to determine bone mass density (BMD). While the latter examination is not a relevant alternative in routine diagnostics due to the high radiation exposure, it represents a valuable alternative in trauma surgery for polytraumatized patients. However, an examination to determine the bone quality would be optimal without radiation exposure and which is collected as part of routine diagnostics for, for example, surgical preparation. This would result in a time, economic and health advantage for patients and the healthcare system. Patients undergoing elective spine surgery usually receive an X-ray and magnetic resonance imaging preoperatively. To date, however, both imaging methods have not been able to adequately determine bone quality. Ehresman et al. determined the Vertebral Bone Quality (VBQ) using data sets from magnetic resonance imaging (MRI) and compared them with DXA data. Overall, by optimizing the evaluation algorithms, it could be possible to determine bone quality using MRI. Based on that the aim of the current work is to calculate the VBQ score with T1, T2 and Separate Target Illumination Radar (STIR) weighting of the lumbar spine and to correlate it with the values ​​of the qCT measurements from the same patients. Since in the field of trauma surgery, patients who often receive a CT and an MRI to treat spinal injuries, there are enough data sets from both diagnostics available. The aim of the study is, on the one hand, to compare the VBQ score according to Ehresman et al. with the BMD and, if necessary, the optimization of the VBQ score by using other weightings in the MRI. It would be desirable to develop the VBQ score with a similar quality to that of the BMD or DXA, so that a DXA or qCT measurement could be dispensed with if necessary.
Keywords: VBQ; QCT; MRI; Osteoporosis