骨质疏松椎体压缩骨折患者MRI脂肪量化结果对经皮椎体成形术术后再骨折的预测价值  

Predictive Value of MRI Fat Quantification Results for Recurrent Fractures After Percutaneous Vertebroplasty in Patients with Osteoporotic Vertebral Compression Fractures

作　　者：白贺威 曹晗 BAI Hewei;CAO Han(Department of Radiology,Luohe Maternal and Child Health Hospital,Luohe 462000,China;Department of Radiology,the Sixth People’s Hospital of Luohe,Luohe 462000,China)

机构地区：[1]漯河市妇幼保健院放射科,河南漯河462000 [2]漯河市第六人民医院放射科,河南漯河462000

出　　处：《河南医学研究》2023年第22期4139-4142,共4页Henan Medical Research

摘　　要：目的 探讨骨质疏松椎体压缩骨折(OVCF)患者磁共振成像(MRI)脂肪量化结果对患者经皮椎体成形术(PVP)术后再骨折的预测价值。方法 前瞻性纳入2020年3月至2022年3月漯河市妇幼保健院收治的148例OVCF患者为研究对象。患者入院后均接受PVP手术治疗,术后随访6个月,统计患者术后再骨折情况。采用MRI脂肪量化技术测量OVCF患者术前椎体骨髓脂肪含量(FF),采用双能X线骨密度吸收计量检测骨矿密度(BMD)。收集患者一般资料及术前骨形代谢标志物水平。采用logistic回归分析OVCF患者PVP术后再骨折的危险因素。绘制受试者工作特征(ROC)曲线,评估术前MRI脂肪量化结果对OVCF患者PVP术后再骨折的预测价值。结果 PVP术后随访6个月,OVCF患者中30例(20.27%)出现再骨折,纳入发生组,其余则纳入未发生组。两组患者年龄、性别、体重指数(BMI)差异无统计学意义(P>0.05)。两组术前骨特异性碱性磷酸酶(BALP)、Ⅰ型胶原交联氨基末端肽(NTXⅠ)及Ⅰ型胶原交联羧基端肽(CTXⅠ)水平比较,差异无统计学意义(P>0.05)。发生组患者术前FF、BMD、骨钙素(BGP)水平高于未发生组(P<0.05)。logistic回归分析结果显示,BMD是OVCF患者PVP术后再骨折发生的保护因素(OR<1,P<0.05),FF是OVCF患者PVP术后再骨折发生的危险因素(OR>1,P<0.05)。绘制ROC曲线,结果显示,术前FF水平预测OVCF患者PVP术后再骨折的曲线下面积>0.7,具有一定预测价值。结论 FF、BMD水平是OVCF患者PVP术后再骨折的独立影响因素,且MRI技术量化结果可预测OVCF患者PVP术后再骨折发生风险。Objective To investigate the predictive value of magnetic resonance imaging(MRI)fat quantification results in patients with osteoporotic vertebral compression fractures(OVCF)for refracture after percutaneous vertebroplasty(PVP).Methods A prospective analysis was conducted in this study.A total of 148 patients with OVCF from the hospital from March 2020 to March 2022 were included as the study subjects.After admission,PVP surgery was performed for all patients,and a follow-up period of 6 months was followed up.Statistics were made on patients’postoperative refractures.MRI fat quantification was used to measure the bone marrow fat fraction(FF)of the vertebral body of OVCF patients before surgery.Dual energy X-ray absorptiometry was used to measure bone mineral density(BMD).Baseline data and preoperative bone metabolism markers were collected.Logistic regression analysis was used to analyze the risk factors for postoperative refracture in patients with OVCF after PVP,and the receiver operating characteristic(ROC)curve was drawn to evaluate the predictive value of preoperative MRI fat quantification results for postoperative refracture in patients with OVCF after PVP.Results During a follow-up of 6 months after PVP surgery,30 patients(20.27%)with OVCF experienced recurrent fractures and were included in the occurrence group,while the rest were included in the non-occurrence group.There was no statistical difference in age,gender and body mass index(BMI)between the two groups of patients(P>0.05).There was no statistical difference in preoperative bone-specific alkaline phosphatase(BALP),N-terminal telopeptide of typeⅠcollagen(NTXⅠ)and carboxy-terminal telopeptide of typeⅠcollagen(CTXⅠ)between the two groups(P>0.05).The preoperative levels of FF,BMD and osteocalcin(BGP)in patients in the occurrence group were higher than those in the non-occurrence group,with a statistical difference(P<0.05).The results of logistic regression analysis showed that BMD was a protective factor for the occurrence of refractures a

关 键 词：骨质疏松椎体 再骨折 脂肪含量 预测价值 

分 类 号：R683[医药卫生—骨科学]