Objective: To evaluate the cortical bone characteristics in the medial column of proximal humerus. Methods: A total of one hundred and three healthy adults who underwent shoulder computed tomography scanning in Tianjing Hospital were included in this study.The subjects were divided into three groups according to the age: group A (20-39 years), group B (40-59 years), and group C (>60 years). Cortical bone mapping (CBM) was used to analyze ordinary clinical CT scans using Stradwin 5.2 software.Colors thickness maps were created for each proximal humerus.The region of interest (ROI) 1-6 were set at three levels of the lateral and medial column of proximal humerus.Cortical thickness (CTh), cortical mass surface density (CMSD), and endocortical trabecular bone mineral density (ECTD) were assessed in the three slices in proximal metaphysis.The impact of age, gender to the cortical bone indices of medial column of proximal humerus were investigated with relative analysis.Cortical indices of the lateral and medial column were compared with independent samples t test. Results: In ROI 2 and 3, men had higher cortical bone values than women, and significant differences in ECTD and CMSD were found in ROI 2, 3 and ROI 2 (t=2.100, 2.238, 2.530, all P<0.05). The lineal regression analysis showed that all cortical indices in ROI 1-3 decreased significantly with age for both women and men (r(2)=0.042-0.248, all P<0.05). In group A-C, the medial columns had higher CTh and CMSD values than lateral sides in plane 1, although significant differences were found only in group A (t=3.696, 3.749, both P<0.05). The highest CTh, CMSD and ECTD of the medial compact bone was detected in ROI 1, followed by ROI 2 and 3 in group A (F=5.867, 6.776, 19.062, all P<0.05). The medial columns had approximately equivalent cortica indices values in ROI 1-3 in group B and C. Conclusion: It indicated that significant regional variation in all cortical parameters exists in the medial column of proximal humerus, and the indices are influenced by gender and age.
目的： 测量健康人群肱骨近端内侧柱的三维解剖数据，分析年龄、性别差异和不同年龄段皮质骨的分布特点。 方法： 2016年12月至2017年12月纳入103名健康人在天津医院进行肩部CT扫描，按照年龄分为3组：A组(20～39岁)31名，B组(40～59岁)35名，C组(>60岁)37名。应用皮质骨测量软件Stradwin 5.2读取CT原始影像数据，生成骨皮质的彩色分布图。在不同横断面1～3，建立肱骨近端骺端内、外侧柱的感兴趣区(ROI 1～6)。测量骨皮质厚度(CTh)、骨皮质密度(CMSD)和皮质下骨小梁密度(ECTD)。对比分析内外侧柱皮质骨属性差异，以及内侧柱皮质骨的性别差异和随年龄变化的特点。内外侧柱皮质骨参数比较采用两独立样本t检验。 结果： 在内侧柱ROI 2、3，骨皮质参数的测量值在男性高于女性，其中差异有统计学意义的是ROI 2的CMSD、ECTD和ROI 3的ECTD值(t＝2.100、2.238、2.530，均P<0.05)。直线回归分析发现，在ROI 1～3的CTh、CMSD和ECTD值随着年龄的增加而有不同程度的降低(r(2)＝0.042～0.248，均P<0.05)。在A、B、C组，内侧壁ROI 1的CTh和CMSD值高于相应外侧壁ROI 4的相应值，仅在A组差异有统计学意义(t＝3.696、3.749，均P<0.05)。在A组，内侧壁ROI 1的CTh、CMSD和ECTD值最高，ROI 2其次，ROI 3最低(F＝5.867、6.776、19.062，均P<0.05)。在B、C组，内侧壁ROI 1～3的CTh和CMSD值差异无统计学意义。 结论： 肱骨近端内侧柱皮质骨区域分布差异明显，其属性变化受到性别、年龄等因素的影响。.
Keywords: Age; Cortical bone; Gender; Proximal humerus.