QCT联合MRI脂肪定量技术对骨质疏松性骨折患者PVP疗效的评估

Evaluation of QCT combined with MRI fat quantification technique in the treatment of PVP in patients with osteoporotic fractures

目的探讨定量CT(QCT)联合磁共振成像(MRI)脂肪定量技术对骨质疏松性椎体压缩性骨折(OVCF)患者经皮椎体成形术(PVP)疗效的评估价值。方法选取2019年4月至2021年4月医院行PVP治疗的165例OVCF患者作为研究对象,所有患者均行QCT联合MRI脂肪定量技术检查并获取相关参数[骨密度(BMD)、脂肪分数(FF)];术后3个月应用Oswestry功能障碍指数(ODI)评价OVCF患者胸腰椎功能恢复状况,术后随访1年,以再发骨折作为随访终点事件,观察患者随访期间骨折再发情况;分析QCT联合MRI脂肪定量技术对OVCF患者PVP近期及远期疗效的评估价值。结果术后3个月,ODI指数评估显示,165例OVCF患者中轻度障碍125例、中度障碍22例,重度障碍18例。术后随访1年,165例OVCF患者骨折再发率为16.36%。不同近期及远期疗效OVCF患者BMD、FF参数比较,差异有统计学意义(P<0.05)。绘制受试者工作特征(ROC)曲线,结果显示BMD、FF单独及联合评估OVCF患者PVP术后轻中度、中重度及轻重度胸腰椎功能障碍的曲线下面积(AUC)均>0.7,具有中等评估价值,且联合评估价值最佳;BMD、FF单独及联合评估OVCF患者PVP术后再发骨折的AUC均>0.7,且联合评估价值最佳。结论QCT联合MRI脂肪定量技术对OVCF患者PVP近期及远期疗效均具有较高的评估价值,可准确反映胸腰椎功能恢复状况和骨折再发情况。

Objective To evaluate the value of quantitative computed tomography(QCT)combined with magnetic resonance imaging(MRI)fat quantification in the efficacy of percutaneous vertebroplasty(PVP)in patients with osteoporotic vertebral compression fractures(OVCF).Methods A total of 165 patients with OVCF who underwent PVP treatment in the hospital from April 2019 to April 2021 were selected as the study subjects.All patients underwent QCT combined with MRI fat quantification technique and obtained relevant parameters(bone mineral density,BMD,fat fraction,FF).Oswestry dysfunction index(ODI)was used to evaluate the recovery of thoracolumbar function in OVCF patients 3 months after the operation.The patients were followed up for 1 year.The recurrence of fracture was taken as the end point of follow-up,and the recurrence of fracture was observed during follow-up.The value of QCT combined with MRI fat quantification technique in evaluating the short-term and long-term effects of PVP in OVCF patients were analyzed.Results Three months after the operation,ODI evaluation showed that 125 patients with mild disorders,22 patients with moderate disorders,and 18 patients with severe disorders in 165 patients with OVCF.The recurrence rate of fractures in 165 patients with OVCF was 16.36%in an 1-year follow-up.There were statistical significant differences in BMD and FF parameters between OVCF patients with different short-term and long-term efficacy(P<0.05).Receiver operating characteristic(ROC)curve was developed,and the result showed that the area under the curve(AUC)of mild to moderate,moderate to severe,and mild to severe thoracolumbar dysfunction of OVCF patients after PVP assessed by BMD and FF alone and in combination were all>0.7,with moderate evaluation value,and the combined evaluation value was the best.The AUC of the recurrent fracture after PVP in OVCF patients assessed by BMD and FF alone and in combination were all greater than 0.7,and the combined assessment value was the best.Conclusion QCT combined with MRI fat quantification technique has high value in evaluating the short-term and long-term effects of PVP in OVCF patients.The technique may accurately reflect the recovery of thoracolumbar function and the recurrence of fracture.