超声背散射法评价松质骨状况的研究

超声背散射法评价松质骨状况及诊断骨质疏松症是近年来医学超声领域内的研究热点之一,现已取得了显著的进展。本文将介绍近年来超声背散射法及其参量评价松质骨状况的研究进展,并分析超声背散射相关参量频谱质心偏移量（SCS）和平均骨小梁间距（TbSp）与骨矿密度（BMD）的相关性。研究结果表明,超声背散射参量与BMD有较高的相关性。最后提出了将来研究中需要努力的方向。     

Amplitude modulation excitation for cancellous bone evaluation using a portable ultrasonic backscatter instrumentation

The ultrasonic backscatter (UB) has the advantage of non-invasively obtaining bone density and structure, expected to be an assessment tool for early diagnosis osteoporosis. All former UB measurements were based on exciting a short single-pulse and analyzing the ultrasonic signals backscattered in bone. This study aims to examine amplitude modulation (AM) ultrasonic excitation with UB measurements for predicting bone characteristics. The AM multiple lengths excitation and backscatter measurement (AM-UB) functions were integrated into a portable ultrasonic instrument for bone characterization. The apparent integrated backscatter coefficient in the AM excitation (AIB_AM) was evaluated on the AM-UB instrumentation. The correlation coefficients of the AIB_AM estimating volume fraction (BV/TV), structure model index (SMI), and bone mineral density (BMD) were then analyzed. Significant correlations (|R| = 0.82-0.93, p < 0.05) were observed between the AIB_AM, BV/TV, SMI, and BMD. By growing the AM excitation length, the AIB_AM values exhibit more stability both in 1.0-MHz and 3.5-MHz measurements. The recommendations in AM-UB measurement were that the avoided length (T1) should be lower than AM excitation length, and the analysis length (T2) should be enough long but not more than AM excitation length. The authors conducted an AM-UB measurement for cancellous bone characterization. Increasing the AM excitation length could substantially enhance AIB_AM values stability with varying analyzed signals. The study suggests the portable AM-UB instrument with the integration of real-time analytics software that might provide a potential tool for osteoporosis early screening.     

Ultrasonic backscatter characterization of cancellous bone using a general Nakagami statistical model

The goal of this study is to analyze the statistics of the backscatter signal from bovine cancellous bone using a Nakagami model and to evaluate the feasibility of Nakagami-model parameters for cancellous bone characterization. Ultrasonic backscatter measurements were performed on 24 bovine cancellous bone specimens in vitro and the backscatter signals were compensated for the frequency-dependent attenuation prior to the envelope detection. The statistics of the backscatter envelope were modeled using the Nakagami distribution. Our results reveal that the backscatter envelope mainly followed pre-Rayleigh distributions, and the deviations of the backscatter envelope from Rayleigh distribution decreased with increasing bone density. The Nakagami shape parameter(i.e., m) was significantly correlated with bone densities(R = 0.78–0.81, p 0.001) and trabecular microstructures(|R| = 0.46–0.78, p 0.05). The scale parameter(i.e.,?) and signal-to-noise ratio(SNR) also yielded significant correlations with bone density and structural features. Multiple linear regressions showed that bone volume fraction(BV/TV) was the main predictor of the Nakagami parameters,and microstructure produced significantly independent contribution to the prediction of Nakagami distribution parameters,explaining an additional 10.2% of the variance at most. The in vitro study showed that statistical parameters derived with Nakagami model might be useful for cancellous bone characterization, and statistical analysis has potential for ultrasonic backscatter bone evaluation.     

Ultrasonic characterization of human cancellous bone using the Biot theory: inverse problem

This paper concerns the ultrasonic characterization of human cancellous bone samples by solving the inverse problem using experimental transmitted signals. The ultrasonic propagation in cancellous bone is modeled using the Biot theory modified by the Johnson et al. model for viscous exchange between fluid and structure. The sensitivity of the Young modulus and the Poisson ratio of the skeletal frame is studied showing their effect on the fast and slow wave forms. The inverse problem is solved numerically by the least squares method. Five parameters are inverted: the porosity, tortuosity, viscous characteristic length, Young modulus, and Poisson ratio of the skeletal frame. The minimization of the discrepancy between experiment and theory is made in the time domain. The inverse problem is shown to be well posed, and its solution to be unique. Experimental results for slow and fast waves transmitted through human cancellous bone samples are given and compared with theoretical predictions.     

Numerical investigation of ultrasound reflection and backscatter measurements in cancellous bone on various receiving areas

In this study, new ultrasound reflection and backscatter measurements in cancellous bone using a membrane-type hydrophone are proposed. A membrane hydrophone made of a piezoelectric polymer film mounted on an annular frame allows an incident ultrasound wave to pass through its aperture because it has no backing material. Therefore, in measurements using the membrane hydrophone, the receiving area could be located independently from the transmitting area. In addition, the size and shape of the receiving area, which corresponded to those of the electrode deposited on the piezoelectric film, could be arranged in various ways. To investigate the validity of the proposed measurements, before bench-top experiments, the reflected and backscattered waves from cancellous bone were numerically simulated using a finite-difference time-domain method. The reflection and backscatter parameters were measured on various receiving areas, and their correlation coefficients with the structural parameters in the cancellous bone were derived. The simulated results suggested that appropriate receiving areas for the reflection and backscatter measurements could exist and that the proposed measurements could be more effective for evaluating bone properties than conventional measurements.     

Frequency dependence of ultrasonic backscatter from human trabecular bone: theory and experiment

A model describing the frequency dependence of backscatter coefficient from trabecular bone is presented. Scattering is assumed to originate from the surfaces of trabeculae, which are modeled as long thin cylinders with radii small compared with the ultrasonic wavelength. Experimental ultrasonic measurements at 500 kHz, 1 MHz, and 2.25 MHz from a wire target and from trabecular bone samples from human calcaneus in vitro are reported. In both cases, measurements are in good agreement with theory. For mediolateral insonification of calcaneus at low frequencies, including the typical diagnostic range (near 500 kHz), backscatter coefficient is proportional to frequency cubed. At higher frequencies, the frequency response flattens out. The data also suggest that at diagnostic frequencies, multiple scattering effects on the average are relatively small for the samples investigated. Finally, at diagnostic frequencies, the data suggest that absorption is likely to be a larger component of attenuation than scattering.     

Anisotropy of the ultrasonic backscatter of myocardial tissue: I. Theory and measurements in vitro

This research addresses the variations in the ultrasonic backscatter from specimens consisting of a suspension of approximately aligned cylindrical scatterers in a fluid medium as a function of the angle of propagation in the sample. Predictions of the angular dependence of backscatter based on the time-domain Born approximation described by Rose and Richardson [J. H. Rose and J. M. Richardson, J. Nondestr. Eval. 3, 45-53 (1982)] were compared with experimental measurements of the backscatter from both tissue-mimicking phantoms consisting of graphite fibers suspended in gelatin and from canine myocardial tissue. The angular dependence of the backscatter was predicted and measured to be maximum for propagation perpendicular to the cylinder axes and minimum for propagation parallel to the axes. Maximum to minimum (i.e., perpendicular to parallel) changes in the integrated backscatter were predicted to be between 5 and 10 dB in the phantom. The corresponding quantity measured in both the phantom and in canine myocardial tissue was approximately 6 dB.     

Vertebral cancellous bone turn-over: microcallus and bridges in backscatter electron microscopy

Backscatter electron microscopy (BSE) is a powerful technique for investigating cancellous bone structure. Its main function is to offer information regarding the degree of mineralization of the tissue within individual trabeculae.

To illustrate the qualitative information that can be drawn from BSE imaging technique, we present a study on human vertebral cancellous bone. This tissue is continuously remodeled through osteoclastic resorption and osteoblastic new bone apposition. It is thought that osteoclastic resorption pits are especially deleterious for vertebral bone architecture since they often perforate the thin trabeculae; the osteoblasts being unable to repair the gap. In addition, excessive stress may also disrupt the architecture in case of trabecular fracture or damage accumulation.

Waves of new bone formation were easy to identify in BSE. Often these waves were connecting both edges of a perforation and called bridges. Additionally, we present a few images of microcallus formations. A microcallus is described as a small mass of woven bone that generally repairs a trabecula. The microstructural aspects of different microcalluses are presented and discussed. Both bridges and microcallus should be considered as examples of the repair porcess since they obviously preserve the connectivity of the trabeculae. However, bridges were much more frequent than microcallus (396 vs 15). Both mechanisms probably illustrate the normal response to different local stimuli.     

In vitro ultrasonic heating of fetal bone

The temperature increase measured in vitro in human fetal femurs exposed to 1 MHz, continuous wave ultrasound at 37 degrees C is reported. The temperature is measured with a thermocouple probe and is given for several gestational ages. The initial rate of the temperature increase in the specimens is evaluated and compared to known values of absorption in soft tissue. For example, the initial rate of temperature increase in the 108-day gestational age specimen resulting from exposure to ultrasound is 30 times greater in the fetal bone than that of soft tissue with an absorption coefficient of 0.05 cm-1.     

Statistics of the envelope of ultrasonic backscatter from human trabecular bone

The paper describes the investigations intended to compare the results of experimental measurements of backscattering properties of the trabecular bone with the results of computer simulations. Ultrasonic RF echoes were collected using two bone scanners operating at 0.58 and 1.3 MHz. The simulations of the backscattered RF echoes were performed using the scattering model of the trabecular bone that consisted of cylindrical and spherical elements uniformly distributed in water-like medium. For each measured or simulated RF backscatter the statistical properties of the signal envelope were determined. Experimental results suggest deviations of the backscattering properties from the Rayleigh distribution. The results of simulation suggest that deviation from Rayleigh distribution depends on the variation of trabeculae diameters and the number of thin trabeculae. Experimentally determined deviations corresponded well to the deviations calculated from simulated echoes assuming trabeculae thickness variation equaled to the earlier published histomorphometric study results.     

Influence of the precision of spectral backscatter measurements on the estimation of scatterers size in cancellous bone

The goal of this study is to propose a model for the ultrasonic frequency-dependent backscatter coefficient in femoral cancellous bone. This model has been developed with success to predict backscatter in human calcaneal bone [Jenson, Ultr. Med. Biol. 2003]. A weak scattering model is used and the backscatter coefficient is expressed in terms of a Gaussian autocorrelation function of the medium. The backscatter coefficient is computed and comparison is made with experimental data for 37 specimens and for frequency ranging from 0.4 to 1.2 MHz. An excellent agreement between experimental data and predictions is found for both the magnitude and the frequency-dependence of the backscatter coefficient. Then, a nonlinear regression is performed for each specimen, and the mean trabecular thickness is estimated. Experimental data and theoretical predictions are averaged over the 37 specimens. We also find a close agreement between theoretical predictions obtained using the Gaussian autocorrelation function (scatterer size=134+/-15 microm) and the mean trabecular thickness (Tb.Th=132+/-12 microm) derived from the analysis of bone 3-D micro-architecture using high-resolution micro-tomography. However, the correlation between individual experimental and estimated Tb.Th values is moderate (R(2)=0.44). The performance of the estimator are limited mainly by two factors: interference noise due to random positioning of the scatterers and attenuation. We show that the fundamental limitation of our estimator due to the speckle noise is around 5 microm for trabecular thickness estimation. This limitation is lower than the observed biological variability which is around 30 microm and should not be a limiting factor for individual prediction. A second limitation is the tremendous attenuation encountered in highly scattering media such as cancellous bone, which results in highly damped backscatter signals. The compensation for attenuation is difficult to perform, and it may be a critical point that limits the precision of the estimator.     

Effect of bone cortical thickness on velocity measurements using ultrasonic axial transmission: a 2D simulation study

In recent years, quantitative ultrasound (QUS) has played an increasing role in the assessment of bone status. The axial transmission technique allows to investigate skeletal sites such as the cortical layer of long bones (radius, tibia), inadequate to through-transmission techniques. Nevertheless, the type of propagation involved along bone specimens has not been clearly elucidated. Axial transmission is investigated here by means of two-dimensional simulations at 1 MHz. We focus our interest on the apparent speed of sound (SOS) of the first arriving signal (FAS). Its dependence on the thickness of the plate is discussed and compared to previous work. Different time criteria are used to derive the apparent SOS of the FAS as a function of source-receiver distance. Frequency-wave number analysis is performed in order to understand the type of propagation involved. For thick plates (thickness>lambdabone, longitudinal wavelength in bone), and for a limited range of source-receiver distances, the FAS corresponds to the lateral wave. Its velocity equals the longitudinal bulk velocity of the bone. For plate thickness less than lambdabone, some plate modes contribute to the FAS, and the apparent SOS decreases with the thickness in a way that depends on both the time criterion and on the source-receiver distance. The FAS corresponds neither to the lateral wave nor to a single plate mode. For very thin plates (thickness< lambdabone/4), the apparent SOS tends towards the velocity of the lowest order symmetrical vibration mode (S0 Lamb mode).     

超声表观积分背散射系数评价新生儿骨状况的可行性研究

新生儿骨发育状况的超声评价有重要意义。本文研究用超声背散射信号来评价新生儿骨发育状况的可行性。提出将超声表观积分背散射系数(AIB)用于评价新生儿松质骨状况,研究了不同超声频率下AIB与婴儿体重、出生天数之间的关系。研究结果表明,足月儿的AIB明显大于早产儿的AIB;足月儿的体重和AIB相关性较弱;早产儿的AIB参数和出生天数具有较高的正相关性(R=0.633)。说明超声背散射信号及其参数AIB可用于评价新生儿松质骨发育状况。     

Proton magnetic relaxation in bone marrow related to age and bone mineral density: low-resolution in vitro studies.

Detailed analysis of proton spin-spin and spin-lattice relaxation behaviors of the bone marrow in the presence of trabecular bone network was performed at low-resolution (B(0) = 0.496T) on rat vertebrae specimens deprived of spinal cord. Two groups of samples, from young and old healthy animals, were investigated before cellular necrosis had started. BMD measurements were carried out to quantify the expected age-related modifications of the trabecular bone network. 1H-MR measurements were also performed on the same samples, deprived of marrow and saturated with water, in order to control the validity of a possible interpretation of the marrow 1H-MR characteristics, in terms of marrow components, and to investigate the possible employment of these samples to study the trabecular bone network properties. We pointed out that: 1) a bimodal distribution of T(2i) and T(1i) values (distinguishing "fast" and "slow" relaxations) describes satisfactorily all the 1H-MR experimental decays; 2) age-related modifications of the trabecular bone network are marked by correlate variations of the BMD value and of the proton spin-spin relaxation rates in water saturated samples; 3) age-related modifications of marrow are underlined by variations of the average value of the "fast" T(2i) and of the "slow" T(1i) relaxation time distributions, which could be attributed to the marrow components different from the fat granules of the adipose cells.Our results suggest that studies in vitro on bone tissue, by 1H-MR techniques at low-resolution, may contribute to a better bone function characterization and, therefore, to a better clinical utilization of MRI techniques.     

An ultrasonic method for measuring the elastic properties of human tibial cortical and cancellous bone

Ultrasonic techniques have been used to measure the elastic properties of bone. Eight human tibiae were used to determine and map the elastic properties of cortical and cancellous bone. The present study shows cortical bone to be at least orthotropic in its material symmetry. The mechanical properties of cortical bone are more homogeneous along the length than around the circumference. The variations in the properties around the quadrant of cortical bone are small, less than 10%, while differences in the properties around the circumference of cancellous bone are more apparent, approximately 5 times those of cortical bone. The elastic properties of cancellous bone exhibited inhomogeneity and some consistency pattern along both the length and the circumference.     

Application of a supervised machine learning algorithm in bone evaluation using ultrasonic backscatter signal

Improving the diagnosis accuracy is essential for the clinical application of osteoporosis evaluation using ultrasonic backscatter signal.In vitro ultrasonic backscatter signals were measured on bone specimens and backscatter parameters were calculated.Using the measured backscatter parameters,the involved cancellous bone specimens were evaluated and classified using support vector machine and adaptive boosting algorithms.Results showed that the accuracy of classification was 80.00%-82.86% and t...     

Application of Biot's theory to ultrasonic characterization of human cancellous bones: determination of structural, material, and mechanical properties

This paper is devoted to the experimental determination of distinctive macroscopic structural (porosity, tortuosity, and permeability) and mechanical (Biot-Willis elastic constants) properties of human trabecular bones. Then, the obtained data may serve as input parameters for modeling wave propagation in cancellous bones using Biot's theory. The goal of the study was to obtain experimentally those characteristics for statistically representative group of human bones (35 specimens) obtained from a single skeletal site (proximal femur). The structural parameters were determined using techniques devoted to the characterization of porous materials: electrical spectroscopy, water permeametry, and microcomputer tomography. The macroscopic mechanical properties, Biot-Willis elastic constants, were derived based on the theoretical consideration of Biot's theory, micromechanical statistical models, and experimental results of ultrasonic studies for unsaturated cancellous bones. Our results concerning structural parameters are consistent with the data presented by the other authors, while macroscopic mechanical properties measured within our studies are situated between the other published data. The discrepancies are mainly attributed to different mechanical properties of the skeleton frame, due to strong structural anisotropy varying from site to site. The results enlighten the difficulty to use Biot's theory for modeling wave propagation in cancellous bone, implying necessity of individual evaluation of input parameters.     

Influence of cancellous bone microstructure on two ultrasonic wave propagations in bovine femur: an in vitro study

The influence of cancellous bone microstructure on the ultrasonic wave propagation of fast and slow waves was experimentally investigated. Four spherical cancellous bone specimens extracted from two bovine femora were prepared for the estimation of acoustical and structural anisotropies of cancellous bone. In vitro measurements were performed using a PVDF transducer (excited by a single sinusoidal wave at 1 MHz) by rotating the spherical specimens. In addition, the mean intercept length (MIL) and bone volume fraction (BV/TV) were estimated by X-ray micro-computed tomography. Separation of the fast and slow waves was clearly observed in two specimens. The fast wave speed was strongly dependent on the wave propagation direction, with the maximum speed along the main trabecular direction. The fast wave speed increased with the MIL. The slow wave speed, however, was almost constant. The fast wave speeds were statistically higher, and their amplitudes were statistically lower in the case of wave separation than in that of wave overlap.     

Microstructural characterization using diffuse backscatter: theory and experiment

A microstructure characterization technique is presented which utilizes the azimuthal moments of backscattered intensity to determine the Legendre moments of the microstructure's phase function. The technique is based on a late-time, diffuse approximate solution to the radiative transfer equation. Monte Carlo simulations are presented indicating that the technique is robust for the first azimuthal moment but less so for higher-order moments.     

Characterization of dense bovine cancellous bone tissue microstructure by ultrasonic backscattering using weak scattering models

A weak scattering model was proposed for the ultrasonic frequency-dependent backscatter in dense bovine cancellous bone, using two autocorrelation functions to describe the medium: one with discrete homogeneities (spherical distribution of equal spheres) and another, which considers tissue as an inhomogeneous continuum (densely populated medium). The inverse problem to estimate trabecular thickness of bone tissue has been addressed. A combination of the two autocorrelation functions was required to closely approximate the backscatter from bovine bone with various microarchitecture, given that the shape of trabeculae ranges from a rodlike to a platelike shape. Because of the large variation in trabecular thickness, both at an intraspecimen and an interspecimen level, thickness distributions for individual trabeculae for each bone specimen were obtained, and dominant trabecular sizes were determined. Comparison of backscatter measurements to theoretical predictions indicated that there were more than one dominant trabecular sizes that scatter sound for most specimens. Linear regression, performed between dominant trabecular thickness and estimated correlation length, showed significant linear correlation (R(2)=0.81). Attenuation due to scattering by a continuous distribution of scatterers was predicted to be linear over a frequency range from 0.3 to 0.9 MHz, suggesting a possibility that scattering may be a significant source of attenuation.