扩散加权成像表观扩散系数在评估女性骨质疏松中的临床应用

The Clinical Application of Apparent Diffusion Coeffcient of Diffusion Weighted Imaging in Evaluating Female Osteoporosis

目的探讨L1-L4椎体及左髋骨质的表观扩散系数(ADC)对女性骨质疏松的临床诊断价值.方法收集临床拟诊骨质疏松的女性患者50例,所有患者均接受双能X线骨密度测量仪(DXA)及MRI扩散成像检查.根据L1-L4椎体及左髋骨密度(BMD)的T值,分为骨量正常组、骨量减少组和骨质疏松组.运用单因素方差分析比较不同组别的ADC值并及使用SNK-q方法对组间进行两两比较,利用Pearson相关分析ADC值与BMD的相关性.采用受试者工作曲线(ROC)评价椎体骨质ADC值与左髋骨质ADC值对骨质疏松的诊断效能.结果不同骨量组的椎体ADC值及左髋值ADC差异具有统计学意义(P<0.05),且各组之间差异具有统计学意义.腰椎及左髋BMD与ADC值均呈正相关(r=0.68,0.71,P<0.05).L1-L4椎体骨质ADC值诊断阈值为0.313×10^(-3)mm^(2)/s及左髋骨质ADC值诊断阈值为0.428×10^(-3)mm^(2)/s时,其诊断骨质疏松的敏感度分别为80.2%、79.8%,特异度分别为75.7%、76.7%.结论腰椎ADC值及左髋ADC值对诊断女性骨质疏松具有一定的作用.

Obejctive To discuss the diagnostic value of apparent diffusion coefficient(ADC)on lumbar spine(L1-L4)and left lip osteoporosis for women.Methods 50 female subjects who were proposed as osteoporosis were recruited who underwent DXA(dual-energy X-ray absorptiometry)and MRI sequences in lumbar vertebrals(L1-L4)and left lips in the same period,who were divided into three groups according to bone mineral density(BMD):normal bone density group,osteopenia group,osteoporosis group.The ADC values for three groups were compared by one-way ANOVA and SNK-q was used to evaluate differences between every two groups.The correlation between ADC value and BMD were analyzed by Pearson's correlation analysis.ROC curve(receiver operating characteristic curve)was used to evaluate the diagnostic effect of ADC value of vertebral body and left hip on osteoporosis.Results ADC values were detected with significant differences for three groups(P<0.05)and there were statistically significant differences between every groups.ADC values positively correlated with BMD(r=0.68,P<0.05)for L1-L4 vertebral and(r=0.71,P<0.05)for left lips.According to ROC curve,when the cut-off points were 0.313 × 10_^(-3),mm^(2)/s and 0.428 × 10_^(-3),mm^(2)/s for L1-L4 vertebral and left lips,the two parameters had a sensitivity of 80.2%,79.8%and a specificity of 75.7%,76.7%in the diagnosis of osteoporosis respectively.Conclusion ADC value can reflect the changes of mineral density in lumbar and hip and can be useful in diagnosis osteoporosis in women.