中国组织工程研究 ›› 2023, Vol. 27 ›› Issue (4): 606-611.doi: 10.12307/2022.966

• 骨与关节图像与影像 bone and joint imaging • 上一篇    下一篇

腰椎MRI椎体骨质量评分评价绝经后女性骨质疏松的严重程度

刘  浩,杨红胜,曾智谋,王力平,杨坤海,胡永荣,屈  波   

  1. 成都医学院第一附属医院骨科,四川省成都市   610500
  • 收稿日期:2021-12-08 接受日期:2022-01-19 出版日期:2023-02-08 发布日期:2022-06-23
  • 通讯作者: 屈波,博士,副主任医师,成都医学院第一附属医院骨科,四川省成都市 610500
  • 作者简介:刘浩,男,1994年生,四川省成都市人,汉族,成都医学院在读硕士,主要从事骨质疏松症的临床研究。
  • 基金资助:
    四川省科技厅项目(2021YFG0324),项目负责人:屈波;四川省中医药管理局(2020LC0073),项目负责人:屈波;成都医学院校基金(CYZ19-23),项目负责人:曾智谋

Lumbar MRI vertebral bone quality score to evaluate the severity of osteoporosis in postmenopausal women

Liu Hao, Yang Hongsheng, Zeng Zhimou, Wang Liping, Yang Kunhai, Hu Yongrong, Qu Bo   

  1. Department of Orthopedics, First Affiliated Hospital of Chengdu Medical College, Chengdu 610500, Sichuan Province, China
  • Received:2021-12-08 Accepted:2022-01-19 Online:2023-02-08 Published:2022-06-23
  • Contact: Qu Bo, MD, Associate chief physician, Department of Orthopedics, First Affiliated Hospital of Chengdu Medical College, Chengdu 610500, Sichuan Province, China
  • About author:Liu Hao, Master candidate, Department of Orthopedics, First Affiliated Hospital of Chengdu Medical College, Chengdu 610500, Sichuan Province, China
  • Supported by:
    a grant from Sichuan Provincial Department of Science and Technology, No. 2021YFG0324 (to QB); Sichuan Provincial Administration of Traditional Chinese Medicine, No. 2020LC0073 (to QB); The Fund of Chengdu Medical College, No. CYZ19-23 (to ZZM)

摘要:

文题释义:
椎体骨质量评分:是基于腰椎MRI T1加权像,通过测量感兴趣区域的信号强度,测量椎体内部信号强度的一种评分方法。因为在骨质疏松椎体内部有骨髓脂肪细胞的增多,可在MRI图像中表现出一种高信号,进而测量出椎体骨质量评分,用于评估是否存在骨质疏松的情况。

背景:尽管目前双能X射线骨密度仪仍是诊断骨质疏松症的金标准,但在进行骨密度测量时会因为椎体疾病、腰椎退行性改变而导致骨密度结果不准确,并且骨密度仅能反映骨强度的60%,这使得许多学者致力于研究骨质疏松症的诊断方法,此次研究致力于通过MRI寻找一种用于筛查或诊断骨质疏松症的检测方法。
目的:探讨基于腰椎MRI的椎体骨质量评分在绝经后女性骨质疏松中评估的作用。
方法:回顾性分析2017年1月至2021年6月在成都医学院第一附属医院诊治的163例绝经后女性的临床资料,根据双能X射线骨密度仪获得的髋部T值,将研究对象分为正常骨密度组(n=48)及骨量减少/骨质疏松组(n=115),并测量出椎体骨质量评分。比较两组一般情况、T值及椎体骨质量评分,分析椎体骨质量评分与髋部T值的关系,并利用受试者工作特征曲线评价该评分预测骨质疏松症的准确度、特异性与敏感性,以及阈值。
结果与结论:①两组体质量指数、高血压史、糖尿病史、长期激素使用史相比差异均无显著性意义(P > 0.05),骨量减少/骨质疏松组年龄高于正常骨密度组,差异有显著性意义(P < 0.05);②骨量减少/骨质疏松组椎体骨质量评分明显高于骨量正常组,差异有显著性意义(P < 0.05);③椎体骨质量评分与股骨颈T值呈中度负相关(r=-0.625,P < 0.01);④椎体骨质量评分预测骨量减少/骨质疏松的准确度为81.9%,诊断骨量减少/骨质疏松的cut-off值为3.08,敏感度为86.1%,特异性为75.0%;⑤提示基于腰椎MRI的椎体骨质量评分对绝经后女性的骨质疏松情况具有良好的评估价值,可作为评估骨质疏松的补充方法以及测量骨质疏松的一种机会性筛查方法。
缩略语:双能X射线吸收法:dual-energy X-ray absorptiometry,DXA;椎体骨质量:vertebral bone quality,VBQ

https://orcid.org/0000-0001-8946-7616 (刘浩)

中国组织工程研究杂志出版内容重点:人工关节;骨植入物;脊柱;骨折;内固定;数字化骨科;组织工程

关键词: 绝经后骨质疏松症, 椎体骨质量评分, 骨质量, 磁共振成像, 骨密度

Abstract: BACKGROUND: Although the current dual-energy X-ray bone densitometer is still the gold standard for the diagnosis of osteoporosis, the results of bone density measurement may be inaccurate due to vertebral disease and degenerative changes in the lumbar spine. Moreover, bone density can only reflect 60% of bone strength, which makes many scholars devote themselves to the study of diagnostic methods for osteoporosis. This study is dedicated to finding a detection method for screening or diagnosing osteoporosis through MRI. 
OBJECTIVE: To explore the role of vertebral bone quality score based on lumbar MRI in the assessment of osteoporosis in postmenopausal women.
METHODS: The clinical data of 163 postmenopausal women diagnosed and treated in the First Affiliated Hospital of Chengdu Medical College from January 2017 to June 2021 were retrospectively analyzed. According to the dual-energy X-ray bone densitometer to obtain the hip T value, the subjects were divided into normal bone density group (n=48) and osteopenia/osteoporosis group (n=115). Vertebral bone quality score was measured. The general conditions, T value and vertebral bone quality score were compared between the two groups. The relationship between VBQ score and hip T value was analyzed. Receiver operating characteristic curve was used to evaluate the score in predicting the accuracy, specificity, sensitivity, and the threshold of osteoporosis.
RESULTS AND CONCLUSION: (1) There was no significant difference in body mass index, history of hypertension, history of diabetes, and history of long-term hormone use between the two groups (P > 0.05). The age of the osteopenia/osteoporosis group was significantly higher than that of the normal bone density group (P < 0.05). (2) Vertebral bone quality score in the osteopenia/osteoporosis group was significantly higher than that in the normal bone mass group (P < 0.05). (3) Vertebral bone quality score and femoral neck T-score showed the moderately negative correlation (r=-0.625, P < 0.01). (4) The accuracy of vertebral bone quality score in predicting osteopenia/osteoporosis was 81.9%; the cut-off value for diagnosing osteopenia/osteoporosis was 3.08, and the sensitivity was 86.1% and the specificity was 75.0%. (5) The vertebral bone quality score based on lumbar MRI has good values in the assessment of osteoporosis in postmenopausal women, and can be used as a supplementary method for the assessment of osteoporosis and an opportunistic sieve for measuring osteoporosis check method.

Key words: postmenopausal osteoporosis, vertebral bone quality score, bone quality, magnetic resonance imaging, bone mineral density

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