1H-MRS与DWI在骨质疏松症中的初步应用  

Preliminary Application of MR Spectroscopy and MR Diffusion-weighted Imaging in Patients with Osteoporosis

作　　者：汤榕彪[1] 汤光宇[1] 刘勇[1] 姚冀平[1] 李伟[1] 韩承元[1] 

机构地区：[1]同济大学附属第十人民医院放射科,上海200072

出　　处：《临床放射学杂志》2009年第12期1664-1668,共5页Journal of Clinical Radiology

基　　金：上海市科委基础研究重点项目(08JC1419500)

摘　　要：目的探讨绝经后女性腰椎骨髓脂肪分数(fatfraction,FF)、表观扩散系数(apparent diffusion coefficient,ADC)值与骨密度(bone mineral densities,BMD)的关系。资料与方法将行腰椎双能量X线吸收测定(dual X-ray absorptionmetry,DXA)的60例绝经后女性根据T值分为3组:骨质正常组(T>-1.0)20例,骨质减少组(T=-1.0～-2.5)20例,骨质疏松组(T<-2.5)20例。所有研究对象均行氢质子磁共振波谱分析(1H MR spectroscopy,1H-MRS)、MR扩散加权成像(diffusion weighted imaging,DWI),分别测定L3椎体FF和ADC值。采用组间t检验对不同骨质组间FF、ADC值差异进行统计学分析。采用Pearson相关分析3组间FF、ADC值与BMD的相关性。结果骨质疏松组脂肪含量[(59.1±8.8)%,P=0.003]与骨质减少组脂肪含量[(54±7.6)%,P=0.039]均比骨质正常组[(49±9.1)%]高。骨质疏松组比骨质减少组椎体脂肪含量高(P=0.045)。椎体骨髓ADC值与T值无相关性。所有绝经后女性患者FF值与T值呈负相关(r=-0.46,P<0.01),与ADC值间呈轻度负相关(r=-0.25,P<0.05),但骨质疏松组中FF值与ADC值间呈较明显负相关(r=-0.72,P<0.01)。ADC值与T值无相关性(r=0.315,P>0.05)。结论绝经女性椎体骨髓脂肪含量随着BMD的减小而增大。MRS可作为BMD检查的辅助手段。MRS与DWI可以无创性了解骨质疏松症患者骨髓的生理、病理变化,单纯DWI并不能反映BMD的改变。Objective To prospectively investigate the relationship among vertebral marrow fat content,marrow apparent diffusion coefficient（ADC）,and bone mineral densities（BMD） documented with dual x-ray absorptiometry （DXA） in postmenopausal women. Materials and Methods Sixty postmenopausal women were divided into normal bone density group（T〉-1.0,20 cases）,osteopenic group（t=-1.0-2.5,20 cases）,and osteoporotic group（T〈-2.5,20 cases） based on T score after DXA examination. Proton magnetic resonance spectroscopy （MRS） and diffusion-weighted MR imaging of the L3 vertebral body were performed with a 1.5-T whole-body MR imaging system. Marrow fat content and apparent diffusion coefficient （ADC） were compared among three bone density groups. The t test was used for comparisons between groups, and the Pearson test was used to determine correlation among marrow fat content, bone density and ADC. Resu- lts Vertebral marrow fat content was significantly increased in osteoporotic group （ 59.1% -＋ 8.8, P 〈 0.01 ） or osteopenic group（54% ＋ 7.6,P 〈 0.05 ） when compared with that of the normal bone density group （49% ＋ 9.1 ）. The difference of that was also significant （ P 〈 0.05 ） between osteoporotic and osteopenic group. The ADC of vertebral marrow did not change with bone density. A mild significant negative correlation was observed between marrow fat content and T score（ r = - 0.46, P 〈 0.01 ）. A negative correlation between vertebral marrow fat content and ADC was significant in the osteoporotic group （ r = - 0.72, P 〈 0.01 ）, though it was slight in all postmenopausal women （ r =- 0.25, P 〈 0.05 ）. No significant correlation was present between bone density and marrow ADC （r = 0. 315 ,P 〉 0.05 ）. Conclusion The subjects with osteoporosis in postmenopausal women experienced a corresponding increase in vertebral marrow fat content as bone density decreased. MRS can be a compensative way for BMD determination. MRS and DWI can noninvasively assess

关 键 词：骨质疏松 磁共振波谱学 扩散加权成像 骨髓 骨密度 

分 类 号：R580[医药卫生—内分泌] R445.2[医药卫生—内科学]