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| 腰椎脂肪定量MR （IDEAL-IQ）技术在骨质疏松症中的应用 |
| The application of MR IDEAL-IQ in patients with osteoporosis |
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| DOI：10.3969/j.issn.1006-7108.2019.12.015 |
| 中文关键词: 磁共振成像 脂肪定量 骨质疏松 腰椎 骨密度 |
| 英文关键词:MR IDEAL-IQ osteoporosis bone mineral density lumbar vertebrae |
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| 中文摘要: |
| 目的 初步研究MR（IDEAL-IQ）技术测量的腰椎椎体骨髓脂肪分数（FF）在骨质疏松症临床诊断中的应用价值。方法 收集2018年6月至2018年11月在我院同时行腰椎脂肪定量MR检查与双能X线骨密度检查的患者，测量椎体（L1~4）脂肪分数和骨密度(常规用T值)，进行Spearman相关分析。根据T值，将患者分为骨量正常组、骨量减少组和骨质疏松组。用单因素方差分析FF值在3组间的差异，用Mann-Whitney非参数检验分析每两组间差异，最后基于受试者工作特征曲线（ROC曲线）分析FF值对骨质疏松症的诊断效能。结果 总共收集病例55例，其中47例纳入数据分析。脂肪分数（FF）与骨密度值呈负相关（r= –0.66，P<0.05），随着椎体骨密度的增高，脂肪分数降低。骨质疏松组与其他两组之间差异均有统计学意义（P<0.05），骨量减少组与正常组之间的P值为0.1，差异没有统计学意义，ROC曲线下面积（AUC）为0.79，选择阈值48.05%来诊断骨质疏松症，灵敏度为0.871，特异性为0.625。结论 MR IDEAL-IQ技术通过快速精准评估腰椎椎体骨髓脂肪含量的变化，能够为骨质疏松症的诊断提供有价值的信息。 |
| 英文摘要: |
| Objective To evaluate the clinical value of vertebral bone marrow fat fraction (FF) measured by MR (IDEAL-IQ) in the diagnosis of osteoporosis. Methods Patients who underwent spinal fat quantitative examination with MR (IDEAL-IQ) and dual-energy X-ray absorptiometry (DXA) were included from June to November 2018. Patients were categorized into normal group, osteopenia group, and osteoporosis group, depending on the bone mineralization levels (T-score) derived from DXA. Spearman ρ test was used to investigate the correlation between FF and BMD. One-way ANOVA was used to analyze the differences among the 3 groups. Mann-Whitney test was performed to compare the difference between the two groups. FF cutoff value for the prediction to osteoporosis was evaluated with the receiver operating characteristic curve analysis. Results Forty-seven patients out of 55 cases were collected. The differences of FF among the 3 groups were statistically significant (P<0.05). The marrow fat FF was negatively correlate with BMD (R=–0.66, P<0.05). With the increase in BMD and decrease in FF, there was significant difference between osteoporosis group and other 2 groups. There was no statistic difference between osteopenia group and normal group (P=0.1). The area under the ROC curve for FF was 0.79 (95% confidence interval 0.65-0.94). The optimal cutoff point was obtained as 48.05%. The sensitivity and specificity were 0.871 and 0.625, respectively. Conclusion IDEAL-IQ can be used as an alternative technique to detect reduced bone mineralization of the vertebrae by estimation of FF value. |
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