采用MRI T_2~*值定量评估腰椎骨质疏松的价值  

Quantitative evaluation of lumber vertebra osteoporosis with MRI T_2~* mapping

作　　者：张晓飞[1] 吴慧钊[1] 韩殊曼 曹磊[1] 闻锦旭 吴文娟[1] ZHANG Xiao-fei;WU Hui-zhao;HAN Shu-man;CAO Lei;WEN Jin-xu;WU Wen-juan(Department of Radiology,the Third Hospital of Hebei Medical University,Shijiazhuang 050051,China)

机构地区：[1]河北医科大学第三医院放射科,河北石家庄050051

出　　处：《河北医科大学学报》2019年第5期575-578,591,共5页Journal of Hebei Medical University

基　　金：河北省科技计划项目(16277701D)

摘　　要：目的探讨采用MRI T_2~*值定量评估腰椎骨质疏松的临床应用价值。方法对87例绝经后老年女性进行腰椎常规(T_1WI及T_2WI)序列、T_2~*mapping序列扫描及定量CT骨密度(bone mineral density,BMD)检查,分别测量L_2～L_4椎体的T_2~*值及L_2～L_4椎体的BMD值。以BMD值为金标准,将检测椎体分入骨质疏松、骨量减少、骨量正常3组中,对测量的T_2~*值及BMD值进行Spearman相关性分析,使用受试者工作特征(receiver operating characteristic curve,ROC)曲线分析T_2~*值诊断腰椎骨质疏松和骨量减少的敏感度、特异度等。结果骨量正常、骨量减少、骨质疏松3组T_2~*值与BMD值均呈负相关(r_s=-0.47、-0.52、-0.57,P<0.05)。ROC曲线显示T_2~*值诊断腰椎椎体骨量减少及骨质疏松的ROC曲线下面积分别为0.76、0.79,取截断值12.48时其诊断骨量减少的敏感度为82.2%、特异度为59.3%,取截断值17.13时其诊断骨质疏松的敏感度为87.1%、特异度为56.2%。结论 MRI T_2~*mapping序列可无创性定量反映腰椎椎体骨质密度并对骨质疏松程度作出评价,具有临床应用价值。Objective To explore the clinical value of MRI T2^*values for quantitative evaluation of the lumbar vertebrae osteoporosis.Methods The patients who underwent the routine lumbar MRI scan,T2^*mapping scan and quantitative computer tomography(QCT)were collected.Bone mineral density(BMD)of the QCT were obtained,and T2^*values of L 2-L 4 were measured by two independent observers.According to the BMD values,the vertebral bodies were divided into the normal group,the osteopenia group and the osteoporosis group.The correlations of T2^*values and BMD were analyzed with Spearman correlation tests.The diagnostic efficiency of T2^*values was evaluated by receiver operating characteristic curve(ROC curve).Results The correlations of the T2^*values and BMD values in all three groups were negative(r s=-0.47,-0.52,-0.57,P<0.05 respectively).The areas under ROC curve of T2^*value for diagnosis of the lumber vertebral osteopenia and osteoporosis were 0.76 and 0.79,respectively.The diagnosis sensitivity was 82.2%and the specificity was 59.3%for diagnosis of osteopenia at the threshold of 12.48,87.1%and 56.2%for the diagnosis of osteoporosis at the threshold of 17.13.Conclusion The MRI T2^*mapping sequence could be a reliable diagnostic indicator for quantitative evaluation of the lumbar vertebrae osteoporosis.

关 键 词：骨质疏松 绝经后 骨密度 诊断显像 

分 类 号：R681[医药卫生—骨科学]