改良正反相位成像法对绝经后女性腰椎骨髓脂肪含量的评价  

Vertebral marrow fat content assessed by modified out-phase and in-phase MR images in post menopausal female

作　　者：蔡建忠[1] 李金奖 田青松 曹代荣[2] CAI Jianzhong;LI Jinjiang;TIAN Qingsong;CAO Dairong(Department of imaging,Shishi City Hospital of Fujian Province,Shishi 362700,P.R.China;Department of Imaging,The First Affiliated Hospital,Fujian Medical University,Fuzhou 350005,P.R.China)

机构地区：[1]福建省石狮市医院影像科,福建石狮362700 [2]福建医科大学附属第一医院影像科,福建福州350005

出　　处：《医学影像学杂志》2019年第12期2126-2130,共5页Journal of Medical Imaging

摘　　要：目的探讨MR多种正反相位成像法对绝经后女性腰椎骨髓脂肪含量的诊断效能。方法前瞻性选择绝经后女性56例,年龄55~83岁,平均年龄(62.8±4.02)岁。全部患者分别应用轻T 1权重正反相位法、重T 1权重正反相位法及三回波正反相位法分别扫描其腰椎,分析三种正反相位法腰椎骨髓脂肪分数比FF的均值;之后全部患者经双能X线骨质密度诊断仪扫描后分成骨量正常组(n=38)、骨量减少组(n=18);应用ROC曲线评价三种正反相位法的腰椎骨髓脂肪FF均值对绝经后女性骨量减少的诊断效能。结果1)轻T 1权重正反相位法骨量减少组的FF均值大于骨量正常组(P<0.05);年龄、体重对FF均值的影响有统计学意义(P=0.002;0.016);FF均值同年龄呈Pearson正相关(r=0.691,P=0.00),FF均值同体重呈Pearson负相关(r=-0.658,P=0.00);2)三回波正反相位法骨量减少组的FF均值大于骨量正常组(P<0.05);年龄、体重对FF均值的影响有统计学意义(P=0.004;0.005);FF均值同年龄呈Pearson正相关(r=0.672,P=0.00),FF均值同体重呈Pearson负相关(r=-0.681,P=0.00);3)重T 1权重正反相位法骨量减少组同骨量正常组的FF均值无统计学意义(P=0.057);4)轻T 1权重正反相位法、三回波正反相位法的腰椎FF均值诊断绝经后女性骨量减少的ROC曲线下面积、诊断阈值、敏感度、特异度分别为0.852、0.871;0.3478、0.3663;81.6%、86.8%;77.8%、72.2%。重T 1权重正反相位法腰椎FF均值诊断绝经后女性骨量减少的ROC曲线下面积0.462。结论轻T 1权重正反相位法、三回波正反相位法的腰椎骨髓脂肪FF均值对绝经后女性腰椎骨髓脂肪含量的诊断有一定的效能。Objective To explore the diagnostic value of the modified out-phase and in-phase MR images for vertebral marrow fat content in the post menopausal female and to compare the diagnostic value of the methods.Methods Fifty-eight patients were enrolled in this study.The age of patients rang from 55 to 83(mean age 62.8±4.02).Thirty-eight patients were diagnosed with osteopenia and eighteen people were diagnosed normal bone marrow using DXA respectively.All the 58 subjects underwent MRI regular examination,minimal T1 weighting out-phase/in-phase MR,heavy T1 weighting out-phase/in-phase MR and out-phase/in-phase/in-phase(three echoes)MR examination.The vertebral marrow mean fat fraction(FF)of L1~L4 vertebra were measured.FF between the two groups were analyzed using covariance.Diagnostic accuracy of FF for osteopenia in the post menopausal female were analyzed using ROC curve,and the diagnostic threshold of these indicators for osteopenia was determined.Results 1)Subjects with osteopenia had higher FF value statistically compared with those with normal vertebralmarrow(P<0.05)afer adjusting age and body weight(P=0.002;0.016 respectively)by using minimal T1 weighting out-phase/in-phase MR;The correlations among age,body weight and FFwere assessed with Pearson analysis.There was a postive Pearson correlation between FF and age(r=0.691,P=0.00),otherwise,there was a negative Pearson correlation between FF and body weight(r=-0.658,P=0.00);2)Subjects with osteopenia had higher FF value statistically compared with those with normal vertebralmarrow(P<0.05)afer adjusting age and body weight(P=0.004;0.005respectively)by using out-phase/in-phase/in-phase(three echoes)MR examination.There was a postive Pearson correlation between FF and age(r=0.672,P=0.00),otherwise,there was a negative Pearson correlation between FF and body weight(r=-0.681,P=0.00);3)There was not statistically significant differences between osteopenia group and normal vertebralmarrow group(P=0.057);4)The area under ROC curve was 0.852 for FF to differentiate oste

关 键 词：正反相位 骨髓脂肪 磁共振成像 

分 类 号：R681.5[医药卫生—骨科学] R445.2[医药卫生—外科学]