In-vivo bone microstructure measured by high-resolution peripheral quantitative computed tomography (HR-pQCT) is gaining importance in research and clinical practice. Second-generation HR-pQCT (XCT2) shows improved image quality and shorter measurement duration compared to the first generation (XCT1). Predicting and understanding the occurrence of motion artifacts is crucial for clinical practice. We retrospectively analyzed data from HR-pQCT measurements at the distal radius and tibia of 1,000 patients (aged 20 to 89) evenly distributed between both generations of HR-pQCT. Motion artifacts were graded between 1 (no motion) and 5 (severe motion), with grades greater 3 considered unusable. Additionally, baseline characteristics and patients’ muscle performance and balance were measured. Various group comparisons between the two generations of HR-pQCT and regression analyses between patient characteristics and motion grading were performed. The study groups of XCT1 and XCT2 did not differ by age (XCT1: 64.9 vs. XCT2: 63.8 years, p = 0.136), sex (both 74.5% females, p > 0.999), or BMI (both 24.2 kg/m², p = 0.911) after propensity score matching. XCT2 scans exhibited significantly lower motion grading in both extremities compared to XCT1 (Radius: p < 0.001; Tibia: p = 0.002). In XCT2 motion-corrupted scans were more than halved at the radius (XCT1: 35.3% vs. XCT2: 15.5%, p < 0.001), and at the tibia the frequency of best image quality scans was increased (XCT1: 50.2% vs. XCT2: 63.7%, p < 0.001). The strongest independent predictor for motion-corrupted images is the occurrence of high motion grading at the other scanning site during the same consultation. The association between high motion grading in one scan and a corresponding high motion grading in another scan within the same session suggests a non-resting patient. Additionally, aged, female, and patients with smaller stature tend towards higher motion grading, requiring special attention to a correct extremity fixation.

通过高分辨率外周定量计算机断层扫描 (HR-pQCT) 测量的体内骨微结构在研究和临床实践中变得越来越重要。与第一代 (XCT1) 相比，第二代 HR-pQCT (XCT2) 显示出更高的图像质量和更短的测量持续时间。预测和理解运动伪影的发生对于临床实践至关重要。我们回顾性分析了 1,000 名患者（年龄 20 至 89 岁）的桡骨远端和胫骨 HR-pQCT 测量数据，这些患者均匀分布在两代 HR-pQCT 之间。运动伪影的分级介于 1（无运动）和 5（严重运动）之间，大于 3 的等级被认为不可用。此外，还测量了基线特征以及患者的肌肉表现和平衡。对两代 HR-pQCT 之间的各组比较以及患者特征和运动分级之间的回归分析进行了分析。XCT1 和 XCT2 研究组在年龄（XCT1：64.9与XCT2：63.8 岁，p  = 0.136）、性别（均为 74.5% 女性，p  > 0.999）或 BMI（均为 24.2 kg/m ²，p  = 0.911) 倾向得分匹配后。与 XCT1 相比，XCT2 扫描显示双肢运动分级显着较低（半径：p  < 0.001；胫骨：p  = 0.002）。在 XCT2 中，半径处的运动损坏扫描减少了一半以上（XCT1：35.3% vs. XCT2：15.5%，p < 0.001），并且在胫骨处，最佳图像质量扫描的频率增加了（XCT1：50.2% vs.  XCT2：50.2%）。XCT2：63.7%，p  < 0.001）。对于运动损坏图像的最强独立预测因素是在同一咨询期间在其他扫描部位出现高运动分级。同一疗程内一次扫描中的高运动分级与另一次扫描中相应的高运动分级之间的关联表明患者处于非休息状态。此外，老年人、女性和身材较小的患者倾向于较高的运动分级，需要特别注意正确的肢体固定。