磁化传递成像及多回波Dixon技术诊断原发性骨质疏松  

Magnetic transfer imaging and multi-echo Dixon technique in diagnosis of primary osteoporosis

作　　者：谭辉 杨震 樊秋菊 于楠 杨创勃 曹丽娜 于勇 李娜[2] 王少彧 TAN Hui;YANG Zhen;FAN Qiuju;YU Nan;YANG Chuangbo;CAO Lina;YU Yong;LI Na;WANG Shaoyu(Department of Medical Imaging,Affiliated Hospital of Shaanxi University of Chinese Medicine,Xianyang 712000,China;School of Basic Medicine and Medical Technology,Shaanxi University of Chinese Medicine,Xianyang 712000,China;Division of MR Research,Siemens Healthineers,Shanghai 201318,China)

机构地区：[1]陕西中医药大学附属医院医学影像科,陕西咸阳712000 [2]陕西中医药大学基础医学与医学技术学院,陕西咸阳712000 [3]西门子医疗系统有限公司磁共振科研部,上海201318

出　　处：《中国医学影像技术》2022年第11期1694-1698,共5页Chinese Journal of Medical Imaging Technology

基　　金：陕西中医药大学学科创新团队建设项目(2019-QN09);陕西中医药大学附属医院院级科研项目(2020QN015)。

摘　　要：目的 观察磁化传递成像(MTI)及多回波Dixon技术诊断原发性骨质疏松的价值。方法 回顾性分析206例接受L2~L4定量CT(QCT)及MR(MTI及多回波Dixon定量技术)检查患者,根据QCT所测骨密度(BMD)将其分为骨质疏松组(BMD<80 mg/cm^(3))、骨量减低组(BMD 80~120 mg/cm^(3))及骨量正常组(BMD>120 mg/cm^(3)),比较3组一般资料、L2~L4椎体磁化传递率(MTR)及脂肪分数(FF)。将差异有统计学意义的参数纳入多因素二元logistic回归分析,建立回归方程,采用受试者工作特征(ROC)曲线,分析其诊断骨质疏松的效能。结果 QCT诊断骨质疏松64例、骨量减低72例、骨量正常70例,3组间年龄、体质量指数(BMI)、BMD、FF及MTR差异均有统计学意义(P均<0.05)。基于多回波Dixon的回归方程为Logist(P_(FF))=0.15×年龄+0.58×BMI+0.04×FF-27.09,基于MTI的回归方程为Logist(P_(MTR))=0.14×年龄+0.63×BMI-0.44×MTR-23.31,联合方程为Logist(P_(FF+MTR))=0.15×年龄+0.63×BMI-0.04×FF-0.52×MTR-20.59,其诊断原发性骨质疏松的曲线下面积(AUC)分别为0.88、0.96及0.98,Logist(P_(FF+MTR))的AUC大于Logist(P_(FF))及Logist(P_(FF))(Z=4.234、P<0.001,Z=1.252,P=0.041)。结论 MTI及多回波Dxion技术均可用于原发性骨质疏松诊断,联合应用二者可提高诊断效能。Objective To explore the value of magnetization transfer imaging(MTI) and multi-echo Dixon technique in diagnosis of primary osteoporosis. Methods Data of 206 patients who underwent quantitative CT(QCT) and MR(including MTI and multi-echo Dixon sequences) examinations of L2—L4 vertebrae were retrospectively analyzed. According to the results of bone mineral density(BMD) measured by QCT, the patients were divided into osteoporosis group(BMD<80 mg/cm^(3)), osteopenia group(BMD 80—120 mg/cm^(3)) or normal control(NC) group(BMD>120 mg/cm^(3)). The general data, magnetization transfer ratio(MTR) and fat fraction(FF) of L2—L4 vertebrae were compared among groups. Parameters being significantly different among groups were enrolled in the multivariate binary logistic regression analysis, and regression equations were established based on FF, MTR and FF+MTR, respectively, and the diagnostic efficacy was analyzed using receiver operating characteristic(ROC) curve. Results There were 64 cases in osteoporosis group, 72 cases in osteopenia group and 70 cases in NC group. Significant differences of age, body mass index(BMI), BMD, FF and MTR were found among 3 groups(all P<0.05). The regression equation based on multi-echo Dixon was: Logist(P_(FF+MTR))=0.15×age+0.58×BMI+0.04×FF-27.09, based on MTI regression equation was: Logist(P_(MTR))=0.14×age+0.63×BMI-0.44×MTR-23.31, while the combined equation was: Logist(P_(FF+MTR))=0.15×age+0.63×BMI-0.04×FF-0.52×MTR-20.59. The area under the curve(AUC) of Logist(P_(FF)), Logist(P_(MTR)) and Logist(P_(FF+MTR)) for diagnosing osteoporosis was 0.88, 0.96 and 0.98, respectively, with that of Logist(P) higher than those of Logist(P_(FF)) and Logist(P_(MTR))(Z=4.234, P<0.001;Z=1.252, P=0.041). Conclusion MTI and multi-echo Dixon technique had certain value in diagnosis of osteoporosis, and the diagnostic efficiency could be improved through MTR combining with FF.

关 键 词：骨质疏松 腰椎 骨密度 磁共振成像 

分 类 号：R681[医药卫生—骨科学] R445.2[医药卫生—外科学]