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| 常规MRI的VBQ评分对椎体骨质量评估及临床意义 |
| VBQ score in conventional MRI for the assessment of vertebral bone quality and its clinical significance |
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| DOI：10.3969/j.issn.1006-7108.2024.11.011 |
| 中文关键词: 骨质疏松症 骨质疏松性椎体骨折 椎体骨质量评分 磁共振成像 双能X线骨密度 T值 |
| 英文关键词:osteoporosis osteoporotic vertebral fracture vertebral bone quality score MRI DEAX T value |
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| 中文摘要: |
| 目的 探讨常规MRI检查下椎体骨质量评分（vertebral bone quality score
，VBQ）在评估骨质疏松性椎体骨折（osteoporotic vertebral fractures，OVF）患者骨质量方面的可行性及其预测OVF的能力。方法 纳入诊断为OVF和非OVF患者。使用非增强T1加权MRI、DEXA （双能X线骨密度）T值和人口统计数据。通过配对t检验分析OVF组和非OVF组VBQ评分差异，通过Pearson相关分析和单变量线性回归分析VBQ评分与DEXA T值之间的关系。利用Logistic回归探究VBQ评分与OVF发生的关联及其他影响因素。通过受试者工作特征曲线（receiver operating characteristic curve，ROC）分析，计算VBQ评分预测OVF和骨质疏松症（osteoporosis，OP）曲线下面积（area under the curve，AUC）。结果 共纳入OVF患者100例，非OVF患者100例。骨折组与非骨折组的VBQ评分差异具有统计学意义（4.17±0.79 vs 3.31±0.53, P < 0.001）。Pearson相关分析表明，VBQ评分与最低T值呈中度负相关（r= – 0.452 , P < 0.001）。Logistics回归提示，VBQ评分是OVF发生的独立因素（OR = 5.857, 95% CI：2.873~11.941, P < 0.000 01）,且比T值（OR = 0.456 ，95% CI：0.304~0.676 , P＜0.000 1）显著性更强。ROC分析得出，VBQ评分预测OVF的AUC为0.817（95% CI: 0.759~0.875, P<0.001），强于T值（AUC=0.799，95% CI: 0.736~0.852, P<0.001）预测OP的AUC 0.756（95% CI: 0.689~0.823, P<0.001），显示出良好的OP预测能力。结论 VBQ评分在预测OVF以及OP方面展现出良好性能，且VBQ评分预测OVF显著性及性能强于T值。相比与骨密度T值，VBQ评分是评估OVF患者骨质量的有效、可靠指标。 |
| 英文摘要: |
| Objective To explore the feasibility of using the vertebral bone quality score (VBQ) under conventional MRI for assessing bone quality in patients with osteoporotic vertebral fractures (OVF) and its capability to predict OVF. Methods Patients diagnosed with OVF and non-OVF were included. Non-enhanced T1-weighted MRI, DEXA (dual-energy X-ray absorptiometry) T-scores, and demographic data were utilized. The differences of VBQ scores between OVF and non-OVF group were analyzed using paired t-tests. The relationship between VBQ scores and DEXA T-scores was examined through Pearson correlation analysis and univariate linear regression. Logistic regression was employed to investigate the association between VBQ scores and OVF occurrence, as well as other influencing factors. The receiver operating characteristic curve (ROC) was used to calculate the area under the curve (AUC) for VBQ scores in predicting OVF and osteoporosis (OP). Results A total of 100 OVF patients and 100 non-OVF patients were included. There was a statistically significant difference in VBQ scores between the fracture and non-fracture group (4.17±0.79 vs 3.31±0.53, P<0.001). Pearson correlation analysis showed a moderate negative correlation between VBQ scores and the lowest T-scores (r = – 0.452, P<0.001). Logistic regression indicated that VBQ scores were independent factors for OVF occurrence (OR = 5.857, 95% CI:2.873-11.941, P<0.00001), significantly stronger than T-scores (OR = 0.456, 95% CI: 0.304-0.676, P<0.0001). ROC analysis revealed that VBQ scores had an AUC of 0.817 (95% CI: 0.759-0.875, P<0.001) in predicting OVF, better than T-scores (AUC=0.799, 95% CI: 0.736-0.852, P<0.001). The AUC for predicting OP was 0.756 (95% CI: 0.689-0.823, P<0.001), demonstrating good predictive capability for OP. Conclusion VBQ scores show good performance in predicting OVF and OP, with significantly stronger predictive capability and performance than T-scores. Compared to bone mineral density T-scores, VBQ scores are an effective and reliable indicator for assessing bone quality in OVF patients. |
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