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

摘要:

[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/cm² vs(0.9±0.1) g/cm² vs (0.7±0.1) g/cm², 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。

Abstract:

[Objective] To investigate the clinical diagnostic value of lumbar bone marrow fat fraction (FF) measured by MRI IDEALIQsequence for osteoporosis (OP), and to search the correlation between FF and bone mineral density, or bone metabolism markers. [Meth-ods] 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 byBMD, 15 patients fall in the normal group, 33 patients were in osteomalacia group and 43 patients were in the OP group. The detection re-sults 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/cm² vs (0.9±0.1) g/cm² vs (0.7±0.1) g/cm², 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 with β-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 with β-CTX,can provide valuable information for the clinical diagnosis of osteoporosis.