磁共振T1WI信号强度评分与老年女性椎体骨质疏松的关系

The relationship between magnetic resonance T1WI signal intensity score and vertebral osteoporotic in elderly women

目的探讨腰椎磁共振成像(MRI)T1WI信号强度评分(M评分)与老年女性椎体骨质疏松的关系。方法回顾性分析进行腰椎MRI检查的>60岁老年女性患者影像学和临床资料,选择急性椎体骨质疏松性压缩骨折患者80例作为病例组,腰椎退变导致椎管狭窄患者100例作为对照组。另选择因下腰痛进行腰椎MRI检查的年轻女性80例作为参考组。测量3组T1WI序列矢状面腰1~腰4的信号噪声比(SNR),使用T1WI信号强度M值评分公式计算每例受检者的M评分值。以单因素方差分析比较病例、对照、参考3组的年龄、腰椎椎体SNR均值及M评分值的差异,以SNK-q法对任意2组间进行比较。于T2WI腰3、腰4横轴位像上测量上终板水平右侧椎旁肌肉及邻近脂肪的信号强度,记录其椎体面积和椎旁肌肉面积,将椎旁肌肉与邻近脂肪的信号强度比值及椎体面积与椎旁肌肉面积比值分别与M评分值进行Pearson相关分析。结果 3组间年龄、腰椎椎体SNR值及M评分值不同(F=246.75、21.47、21.47,P<0.05),经SNK-q法两两比较,可认为病例组与对照组的年龄、腰椎椎体SNR值及M评分值差异无统计学意义(P>0.05),且均大于参考组,腰3、腰4椎旁肌肉与邻近脂肪的信号强度比值及腰4椎体面积与椎旁肌肉面积比值与M评分值均相关(r=0.26、0.36、0.51,P<0.05)。结论与青年女性参考组相比,老年女性对照组及腰椎椎体骨质疏松骨折组的T1WI信号强度增高, M评分可一定程度上反映老年女性的腰椎骨质疏松情况。

Objective To investigate the relationship between magnetic resonance T1 WI signal intensity score and vertebral osteoporotic in elderly women. Methods The imaging and clinical data of elderly women over 60 years who underwent lumbar MRI examination in our hospital were retrospectively analyzed. The 80 patients with acute vertebral osteoporotic compression fracture were enrolled case group, and 100 patients with spinal stenosis caused by lumbar degeneration were enrolled as control group,at the same time, the other 80 young women who underwent routine T1 WI examination of lumbar spine due to low back pain were enrolled as reference group. The signal-to-noise ratio(SNR) of sagital T1 WI sequence was measured, and the M-score of each patient was calculated coording to T1 WI signal intensity. The differences of age, mean value of SNR and M score of lumbar vertebrae among the three groups were compared by One-way ANOVA, and SNK-q method was used to compare the differences in any two groups. The signal intensities of right paravertebral muscle and adjacent fat at upper endplate level were measured on transverse axial images of L3 and L4 on T2 WI. Moreover the vertebral body area and paravertebral muscle area were recorded. Pearson correlation analysis was performed between signal intensity ratio with M score and area ratio, respectively. Results There were significant differences in the patient’s age,SNR values and M scores of lumbar vertebrae among the three groups(P<0.05).However there were no significant differences in the patient’s age,SNR values and M scores of lumbar vertebrae between case group and control group,which in the two groups were greater than those in reference group.In addition the signal intensity ratio of L3 and L4 paravertebral muscles to adjacent fat and the ratio of L4 vertebral body area to paravertebral muscle area were correlated with M score(r=0.26,0.36,0.51,respectively P<0.05). Conclusion As compared with that in reference group, the T1 WI signal intensity in control group and case group is increased,and M score can reflect the degree of lumbar vertebrae osteoporosis in elderly women to a certain extent.