磁共振IDEAL-IQ评价骨质疏松症的价值

Significance of MRI IDEAL-IQ used for diagnosis of osteoporosis

[目的]探讨MRI IDEAL-IQ法测定腰椎骨髓脂肪分数(fat fraction,FF)对骨质疏松(osteoporosis,OP)的临床诊断价值,并分析FF与骨密度、骨代谢指标之间的相关性。[方法]2022年1月—2023年2月在本院骨科住院或门诊的91例患者纳入本研究,行双能X线骨密度(bone mineral density,BMD)检查,腰椎常规序列及IDEAL-IQ序列扫描和骨代谢指标检测。根据BMD检测的T值将患者分成三组,骨量正常组15例、骨量降低组33例和OP组43例。比较三组间检测结果,分析FF与相关参数的相关性,采用ROC分析上述检测诊断OP的效能。[结果]正常组、骨量降低组和OP组三组间的BMD[(1.1±0.1)g/cm^(2)vs(0.9±0.1)g/cm^(2)vs(0.7±0.1)g/cm^(2),P<0.001]、FF值[(82.9±10.2)%vs(75.0±6.8)%,vs(75.8±9.2)%,P<0.05]、β-CTX[(345.7±113.0)ng/ml vs(547.7±236.7)ng/ml vs(617.5±165.3)ng/ml,P<0.05]的差异均有统计学意义,但是三组间P1NP的差异无统计学意义(P>0.05)。相关性分析表明:FF值与BMD呈显著负相关(r=-0.396,P<0.05),与β-CTX呈显著正相关(r=0.238,P<0.05),与P1NP无显著相关性(r=0.081,P>0.05)。ROC曲线下面积(area under cure,AUC)由大至小依次为FF(0.786)>β-CTX(0.652)>P1NP(0.622)>BMD(0.033)。当FF诊断阈值为78.0%时,其特异性为67.8%,敏感性为86.0%。[结论]通过磁共振IDEAL-IQ技术成像的FF值与BMD呈显著负相关,与β-CTX呈显著正相关,能够为临床上诊断骨质疏松症提供有价值的信息。

[Objective]To investigate the clinical diagnostic value of lumbar bone marrow fat fraction(FF)measured by MRI IDEAL-IQ sequence for osteoporosis(OP),and to search the correlation between FF and bone mineral density,or bone metabolism markers.[Methods]From January 2022 to February 2023,91 inpatients or outpatients of the Orthopedic Department of our hospital were enrolled in thisstudy.Dual-energy X-ray bone mineral density(BMD)examination,lumbar routine MRI sequence and IDEAL-IQ sequence scanning,andblood bone metabolism markers detection were performed.The patients were divided into three groups according to the T value measured by BMD,15 patients fall in the normal group,33 patients were in osteomalacia group and 43 patients were in the OP group.The detection results among the three groups were compared,the correlation between FF and related parameters was analyzed,and the efficiency of theabove detections in diagnosing OP was analyzed by ROC.[Results]The BMD[(1.1±0.1)g/cm^(2) vs(0.9±0.1)g/cm^(2) vs(0.7±0.1)g/cm^(2),P<0.001],FF[(82.9±10.2)%vs(75.0±6.8)%vs(75.8±9.2)%,P<0.05],β-CTX[(345.7±113.0)ng/ml vs(547.7±236.7)ng/ml vs(617.5±165.3)ng/ml,P<0.05]were significantly different among the normal group,osteomalacia group and OP group,despite insignificant difference inP1NP among the three groups(P>0.05).In term of correlation analysis,the FF value was significantly negatively correlated with BMD(r=-0.396,P<0.05),whereas significantly positively correlated withβ-CTX(r=0.238,P<0.05),and had no significant correlation with P1NP(r=0.081,P>0.05).In term of ROC analysis,the area under cure(AUC)was ranked up-down as FF(0.786)>β-CTX(0.652)>P1NP(0.622)>BMD(0.033).When the diagnostic threshold of FF was of 78.0%,its specificity was of 67.8%and sensitivity of 86.0%.[Conclusion]TheFF value of MRI IDEAL-IQ sequence is significantly negatively correlated with BMD,while significantly positively correlated withβ-CTX,can provide valuable information for the clinical diagnosis of osteoporosis.