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| 基于MRI成像的VBQ评分对骨质疏松筛查的诊断效能 |
| Analysis of diagnostic efficacy of MRI-based VBQ score for screening osteoporosis |
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| DOI：10.3969/j.issn.1006-7108.2025.06.010 |
| 中文关键词: 磁共振成像 腰椎 骨质疏松症 椎体骨质量 骨密度 |
| 英文关键词:magnetic resonance imaging lumbar spine osteoporosis vertebral bone quality bone mineral density |
| 基金项目:河北省财政厅专科带头人培养项目（LS201804） |
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| 中文摘要: |
| 目的 分析基于磁共振成像(magnetic resonance imaging，MRI)的椎体骨质量（VBQ）评分与骨密度（BMD）的相关性，进一步评价VBQ评分对骨质疏松症的诊断效能。方法 回顾性分析2022年1月至2023年12月在河北医科大学第一医院行腰椎MRI扫描及腰椎定量CT检查的139例患者的影像及临床资料。通过计算矢状位T1WI L1~4椎体的信号强度（SI）除以L3水平椎管内脑脊液的SI获得VBQ评分。使用定量CT测量L1~3椎体的BMD值。根据QCT骨质疏松症诊断标准，将患者分为骨量正常组、骨量减少组及骨质疏松组。采用单因素方差分析比较多组间参数的差异,两两比较应用LSD法。VBQ评分与BMD的相关性分析采用Pearson相关性检验，采用ROC曲线分析VBQ评分对骨质疏松及骨量减少的诊断效能。结果 骨量正常、骨量减少及骨质疏松组间VBQ评分分别为2.37±0.31、2.77±0.42和2.90±0.54，三组间有显著性差异（P＜0.05）。VBQ评分与QCT测量的BMD呈中等程度负相关（r = – 0.68, P＜0.01）。ROC曲线分析显示VBQ评分预测骨质疏松的AUC值为0.84、阈值为2.90、敏感性为78.70 %、特异性为76.60 %。VBQ评分预测骨量正常的AUC值为0.88、阈值为2.55、敏感性为79.31 %、特异性为87.27 %。结论 基于MRI成像的VBQ评分对于骨质疏松症有一定的预测能力，VBQ评分可以作为一种无创性筛查骨质疏松症的新方法。 |
| 英文摘要: |
| Objective To analyze the correlation between VBQ and spine QCT BMD measurements and to assess the diagnostic efficacy of MRI-based VBQ score for osteoporosis diagnosed with QCT. Methods The imaging and clinical data of 139 patients who underwent lumbar quantitative CT and MRI scans in our hospital from January 2022 to December 2023 were retrospective analyzed. The VBQ score was calculated by dividing the signal intensity（SI）of the L1-4 vertebral bodies by the SI of the cerebrospinal fluid at the L3 level on midsagittal T1-weighted MRI images. For BMD assessment, quantitative computed tomography (QCT) measurements of L1-3 were performed. According to the diagnostic criteria of QCT osteoporosis, patients were categorized into normal BMD, osteopenia, and osteoporosis. To compare the differences in parameters among multiple groups, the one-way analysis of variance was used. LSD method was used for pairwise comparison. VBQ scores were compared with QCT BMD using Pearson’s correlation. To analysis the diagnostic efficacy of VBQ score for osteoporosis, the receiver operating characteristic (ROC) analysis was performed. Results The VBQ scores of normal BMD, osteopenia, and osteoporosis groups were 2.37 ± 0.31, 2.77 ± 0.42, and 2.90 ± 0.54, respectively, with significant differences among the three groups (P<0.05). The VBQ score showed negative correlation with QCT BMD (r = – 0.68, P<0.01). Using a VBQ score cutoff value of 2.90, the categorical VBQ score yielded a sensitivity of 78.70 % and a specificity of 76.60 % with an AUC of 0.84 to predicting osteoporosis. Using a VBQ score cutoff value of 2.55 achieved a sensitivity of 79.31 %, a specificity of 87.27 %, and an area under the curve (AUC) of 0.88 for the determination of normal BMD. Conclusion The VBQ score has a certain predictive ability for osteoporosis. It can be used as a new non-invasive screening method for osteoporosis. |
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