腰椎MR扩散加权成像对骨质疏松的定量诊断价值  

The Clinical Value of MR Diffusion-Weighted Imaging in Quantitatively Evaluating Osteoporosis of Lumbar Spine

作　　者：何杰[1] 方浩[1,2] 李晓娜[1] 崔建岭[1] 

机构地区：[1]河北医科大学第三医院,CT/MR,室,河北省骨科生物力学重点实验室,石家庄050051 [2]天津中医药大学附属第一医院影像科

出　　处：《临床放射学杂志》2015年第5期763-767,共5页Journal of Clinical Radiology

摘　　要：目的探讨腰椎扩散加权成像（DWI）对骨质疏松的评估价值,研究不同性别的差异及表观扩散系数（ADC）值与定量CT（QCT）所测骨密度（BMD）的相关性。方法对124名健康志愿者进行腰椎常规MR及DWI扫描,DWI采用自旋回波单次激发回波平面成像（SE-EPI）序列（b值为0和600 s/mm2）,矢状位扫描,测量L2～4椎体ADC值。随即行L2～4椎体QCT检查,采用Mindways公司QCT分析软件进行BMD测量,根据国际临床骨密度协会（ISCD）推荐的诊断标准,分为骨量正常组、骨密度减少组及骨质疏松组,比较不同性别各组间的差异,分析ADC值与BMD的相关性。结果 （1）男性各组间ADC值差异无统计学意义（P〉0.05）,偏相关分析,ADC值与BMD无相关性（P〉0.05）。（2）女性ADC值随BMD减少而降低,骨量正常组[ADC值（0.450±0.130）×10-3mm2/s]与骨量减少组[（0.303±0.068）×10-3mm2/s]及骨质疏松组[（0.287±0.048）×10-3mm2/s]差异有统计学意义（P〈0.001）。偏相关分析,ADC值与BMD呈正相关（r=0.307,P〈0.05）。（3）在骨量正常组中,女性ADC值[（0.450±0.130）×10-3mm2/s）]高于男性[（0.310±0.087）×10-3mm2/s]（P〈0.01）。结论腰椎骨髓扩散有性别差异,女性腰椎ADC值与BMD呈正相关,DWI可对女性骨质疏松的椎体做定量评价,可以反映BMD的变化。Objective To evaluate diffusion weighted imaging （DWI） in diagnosing osteoporosis, and to investigate the correlations between apparent diffusion coefficient （ ADC ） and bone mineral density （ BMD ） determined by quantitative computed tomography （QCT）. Methods A total of 124 healthy subjects underwent routine MRI examination （sagittal T2 WI, T1 WI and axial T2 WI）. Then sagittal DWI was performed with single shot spin-echo planar imaging sequence （ b =0 and b = 600 s/mm2 ） , and ADC values were measured. Volumetric bone mineral density measurement was performed by QCT at lumbar spine area （ L2 - L3 ） by using Midways QCT analysis software. According to diagnosis criteria of osteoporo- sis recommended by the international society for clinical densitometry （ISCD）, the subjects were divided into three groups： normal group, osteopenia group and osteoporosis group. The differences in ADC values between different groups and between males and females were analyzed, and the correlations between ADC values and BMD were evaluated. Results （1） In male subjects, no statistically significant difference in ADC values existed between each other among the three groups （P 〉 0.05 ）. ADC values bore no definite correlation with BMD （P 〉 0.05 ）. （2） In female subjects, ADC values reduced as BMD decreased. ADC values of normal group, osteopenia group and osteoporosis group were （0. 450 ± 0. 130）×10-3mm2/s, （0. 303 ±0. 068）×10-3mm2/s and （0. 287 ±0. 048）×10-3mm2/s respectively; the differences were statistically significant between normal group and osteopenia group as well as between normal group and osteoporosis group （ P 〈 0. 001 ）. ADC values were positively correlated with BMD values （ r = 0. 307, P 〈 0.05 ）. （ 3 ） In normal group, ADC values of females and males were （0.450 ±0. 130）×10-3mm2/s and （0. 310±0. 087 ）×10-3mm2/s respectively; female＇ s ADC value was significantly higher than male＇ s ADC value （ P 〈 0.01 ）. Conc

关 键 词：骨密度 骨质疏松 磁共振扩散成像 计算机体层摄影术 

分 类 号：R445.2[医药卫生—影像医学与核医学] R580[医药卫生—诊断学]