摘要
[目的]探讨MRI脂肪量化技术(IDEAL-IQ)在骨质疏松椎体压缩骨折(osteoporotic vertebral compression fracture,OVCF)中的意义。[方法]回顾性收集147例行腰椎MRI常规序列、IDEAL-IQ序列及双能X线仪(dual-energy X-ray absorptiometry, DXA)检查的骨密度(bone mineral density, BMD),根据患者椎体是否骨折分为骨折组(82例)及非骨折组(65例)。在GE后处理工作站上进行L1~4椎体骨髓脂肪含量(fat fraction, FF)定量测量。单项因素比较两组间差异,分析FF值与BMD的相关性,以是否骨折的二分变量为因变量行二元多因素逻辑回归分析,以及FF值对OVCF的诊断效能。[结果]单项因素比较表明,骨折组年龄显著大于非骨折组(P<0.05),两组间性别构成的差异无统计学意义(P>0.05),骨折组BMI显著低于非骨折组(P<0.05),骨折组的BMD显著低于非骨折组(P<0.05),骨折组的L1~4椎体FF,以及平均FF均显著高于非骨折组,差异均有统计学意义(P<0.05)。逻辑回归分析显示,年龄(OR=2.923,P<0.05)、FF (OR=1.095,P<0.05)是骨折的独立危险因素,而BMD是骨折的保护因素(OR=0.022,P<0.05)。FF与BMD呈显著负相关(r=-0.717,P<0.05)。FF判断椎体骨折的ROC曲线下面积为0.776,诊断骨折的临界值为54.03。[结论]随着椎体脂肪含量的增加,患者发生OVCF风险也逐渐增大,磁共振IDEAL-IQ技术通过对椎体脂肪含量的量化,为研究骨质疏松性椎体骨折提供了一种新的方法。
[Objective] To explore the significance of MRI fat quantification(IDEAL-IQ) in predicting osteoporotic vertebral compression fractures(OVCF). [Methods] A retrospective study was conducted on 147 patients who had examinations performed, involving lumbar MRI routine sequence, IDEAL-1 Q sequence and dual-energy X-ray absorptiometry(DXA) for bone mineral density(BMD). Based on whether OVCF found, the patients were divided into fracture group(82 cases) and non-fracture group(65 cases). The L1~4 vertebral bone marrow fat content(fat fraction, FF) was quantitatively measured on the GE post-processing workstation. The univariate comparison was conducted between the two groups, while the correlation between the FF and BMD was search by Pearson.s linear analysis. In addition, binary multivariate logistic regression analysis was performed with the dichotomous variable of fracture as the dependent variable, while the diagnostic power of the FF value for OVCF was assessed by ROC curve. [Results] In term of univariate comparison, the fracture group was significantly older than that of the non-fracture group(P<0.05), despite of that the difference in gender composition between the two groups was not statistically significant(P>0.05). In addition, the fracture group had significantly lower body mass index(BMI)(P<0.05),and significantly lower BMD than the non-fracture group(P<0.05). Furthermore, the fracture group had significantly higher FF from L1 to L4 and on average than the non-fracture group(P<0.05). There was a significantly negative correlation between FF and BMD(r=-0.717, P<0.05). As results of logistic regression analysis, the advanced age(OR=2.923, P<0.05) and high FF(OR=1.095, P<0.05) were independent risk factors for the fractures, while high BMD was a protective factor for the fractures(OR=0.022, P<0.05). The FF predicting OVCF had area under the curve of 0.776, and the critical value for the diagnosis of 54.03. [Conclusion] With the increase of vertebral body fat content,the risk of OVCF also gradually increases. The magnetic resonance IDEAL-IQ technique quantifies the vertebral body fat content and provides a new way for the study of osteoporotic vertebral compression fractures.
作者
孙文路
刘姣姣
郭兴满
陈华芳
秦健
SUN Wen-lu;LIU Jiao-jiao;GUO Xing-man;CHEN Hua-fang;QIN Jian(Department of Medical Imaging,The Second Affiliated Hospital,Shandong First Medical University,Tai'an 271000,China)
出处
《中国矫形外科杂志》
CAS
CSCD
北大核心
2021年第10期870-874,共5页
Orthopedic Journal of China
基金
山东第一医科大学“学术提升计划”项目(编号:2019QL017)。
关键词
腰椎
骨质疏松
骨质疏松性椎体压缩骨折
骨髓
脂肪含量
lumbar spine
osteoporosis
osteoporotic vertebral compression fracture
bone marrow
fat content
作者简介
孙文路,硕士生,研究方向:医学影像诊断,(电话)15621560518,(电子信箱)805642301@qq.com;通信作者:秦健,(电子信箱)sdqinjian@126.com。
