磁化传递成像评估原发性骨质疏松症的价值

The Value of Magnetization Transfer Imaging in the Evaluation of Primary Osteoporosis

目的:探讨磁化传递成像(MTI)定量评估原发性骨质疏松症的应用价值。方法:回顾性分析159例行腰椎MR检查患者的资料,根据定量CT(QCT)结果分成骨质疏松组、骨量减低组和骨量正常组3组。测量腰2~4椎体磁化传递率(MTR)。比较组间MTR值的差异,绘制ROC曲线以分析MTR对骨质疏松及骨量减低的诊断效能。结果:随着骨密度的降低,椎体MTR值也减低,差异有统计学意义(P<0.001)。MTR值诊断骨量减低与骨质疏松的ROC曲线下面积(AUC)分别为0.875、0.944,MTR阈值分别为10.45、5.95,其诊断骨量减低、骨质疏松的灵敏度分别为78.90%、86.41%,特异度分别为86.84%、89.83%(P<0.001)。结论:MTI技术可以早期、灵敏地检测骨量变化,MTR值可作为骨质疏松症进展的生物学标志物。

Purpose:To explore the application value of magnetization transfer imaging(MTI)in quantitative assessment of primary osteoporosis.Methods:The data of 159 subjects who underwent lumbar magnetic resonance examination were retrospectively analyzed and divided into three groups including osteoporosis group,osteopenia group,and normal bone mineral density(BMD)group based on quantitative CT(QCT)examination.The magnetization transfer rate(MTR)value of lumbar vertebrae 2-4 was measured.The differences of MTR values among the three groups were compared.The ROC curve was drawn to analyze the diagnostic performance of MTR for osteoporosis and osteopenia.Results:With the decrease of BMD,the MTR of vertebral body decreased,and the difference was statistically significant(P<0.001).The area under the ROC curve(AUC)of the diagnostic osteopenia and osteoporosis were 0.875 and 0.944,respectively,and the MTR thresholds were 10.45 and 5.95,respectively,and the sensitivity of the diagnosis of osteopenia and osteoporosis was 78.90%,86.41%,and the specificity was 86.84%,89.83%,respectively(P<0.001).Conclusion:MTI can sensitively reflect the change of bone mass in the early stage,and MTR value can be used as a biomarker of the progress of osteoporosis.