基于影像的骨结构非线性有限元建模及其在骨折风险预测中的应用

Image-based Nonlinear Finite Element Modeling of Bone Structure and its Application to the Prediction of Fracture Risk

准确评价患者的骨折风险能够鉴别高风险人群,以便于采取相应的预防治疗措施。骨折的诱因是多方面的,最主要是力学强度的降低。因此,根据临床已知信息更好地预测与骨强度相关的骨折风险,是一个非常重要的研究课题。计算、建模和影像重建技术的发展,使获得骨结构的三维几何形态和预测骨强度成为可能。基于影像的个体化有限元建模是无创研究骨强度的一个强大手段,对于更为准确地评价骨强度和相关骨折风险,是一个非常重要的工具。本文以本课题组近几年来进行的细观椎体松质骨、腰椎和股骨近端结构的基于影像的非线性有限元建模为例,具体介绍了建模过程及其在骨折风险预测中的应用,并对该方法如何进一步提高骨强度预测精度进行了展望。

Accurately assessing bone fracture risk in patients would enable those at high risk to be identified so that preventive measures could be taken.The causation of fracture is multifactorial,but a major contributor is the reduced bone strength.Hence,the development of better measures of bone strength associated with fracture risk using the clinically available information is an important research and clinical direction.With the development of computing power,modeling and reconstruction of imaging,it is possible to obtain the three-dimensional（3D） geometric morphology and predict bone strength.The development of image-based subject-specific finite element modeling is a powerful tool to non-destructively investigate bone strength,which is important to accurately assess bone strength and the related fracture risk.In this paper,the image-based nonlinear finite element modeling of vertebral trabecular bone,L4-L5 lumbar spinal segment,and proximal femur were taken as examples to introduce the modeling process and itsapplication to the prediction of fracture risk.In addition,some insights on how to improve the prediction of bone strength with this method were provided.