髋部骨质疏松的动态增强磁共振成像研究  

Research on Hip Osteoporosis Using Dynamic Contrast-enhanced MR Imaging

作　　者：张思伟[1] 许鸿新[1] 罗建东[1] 

机构地区：[1]广州中医药大学第二临床医学院二沙岛分院影像科,510105

出　　处：《实用医学杂志》2010年第8期1338-1341,共4页The Journal of Practical Medicine

基　　金：广州中医药大学科研创新基金项目(编号:08CX74)

摘　　要：目的:探讨骨质疏松(OP)患者髋部骨髓血流灌注特征及其与骨密度的相关性。方法:选择60例志愿者行双能X线骨密度及动态增强磁共振检查,根据骨密度结果分为正常对照组30例,骨密度异常者30例,其中骨量减少组16例和骨质疏松组14例。分别测量各研究对象动态增强曲线(TIC)增强后的最大信号强度、到达峰值的时间和SI/sec,比较各组间不同部位感兴趣区各参数值的差异,分析其微循环血流灌注特点。结果:(1)OP组最大信号强度(SImax)和最大斜率(SI/sec)低于正常对照组(P<0.01)及骨量减少组(P<0.01),其TIC曲线最为平缓,SImax值亦最低。(2)股骨头,股骨颈及大粗隆区的SImax和SI/sec均与整体髋BMD值呈正相关(均P<0.01)。结论:骨量减少及OP患者股骨近端血液灌注低于正常人,动态增强磁共振可以通过观察股骨近端血流灌注的异常来预测OP的发生。Objective To investigate the characteristics of femoral bone marrow perfusion and the relationship between bone mineral density and bone marrow perfusion in patients with osteoporosis. Methods DXA and dynamic contrast-enhanced MR imaging of the hip were performed in 60 volunteers. According to BMD, all volunteers were divided into normal group （30 cases）and case group （30 cases）, which were aslo divided into osteopenia group （16 cases） and osteoporosis group （14 cases）. The maximum percentage of enhancement at first past,time to peak and maximum slope of dynamic contrast-enhanced curves （TIC）were evaluated.The values of different ROI were compared in all objects to analyze their characteristics of microcirculation blood flow. Results （ 1 ） Maximum enhancement and enhancement slope were significantly reduced in subjects with osteoporosis compared with subjects with osteopenia （P 〈 0.01 ） or normal group （P 〈 0.01 ）. Curve for subjects with osteoporosis shows the least maximum enhancement and the flattest enhancement slope. （2）There were significant positive correlations between BMD and maximum enhancement and enhancement slope of femoral head, femoral neck and Great trochanter regions （all P 〈 0.01 ）. Conclusion Bone marrow perfusion throughout the proximal femur are reduced in osteopenie and osteoporotic subjects compared with normal subjects. Dynamic contrast-enhanced MR could be used to predict the occurrence of osteoporosis by observing abnormalities of proximal femoral perfusion.

关 键 词：骨质疏松 磁共振成像 髋关节 

分 类 号：R580[医药卫生—内分泌] R445.2[医药卫生—内科学]