骨髓脂肪对骨转移的影响及磁共振成像定量评估  

Effect of bone marrow fat on bone metastasis and quantitative evaluation by magnetic resonance imaging

作　　者：谢青霖 张晓东 Xie Qinglin;Zhang Xiaodong(Department of Imaging,Third Affiliated Hospital of Southern Medical University(Guangdong Orthopedics Research Institute),Guangzhou 510630,Guangdong Province,China)

机构地区：[1]南方医科大学第三附属医院(广东省骨科研究院)影像科,广东省广州市510630

出　　处：《中国组织工程研究》2025年第1期128-135,共8页Chinese Journal of Tissue Engineering Research

基　　金：南方医科大学第三附属医院院长基金(YM2021012),项目负责人:张晓东。

摘　　要：背景:早期骨转移的准确诊断对治疗方案和预后有着至关重要的作用。骨活检是骨转移诊断的金标准,但由于有创且标本尺寸小等缺点,在实际临床工作中难以落实。近年来,随着MRI技术的不断发展,磁共振定量成像技术如磁共振波谱成像、基于化学移位编码的水脂肪成像等被广泛应用于骨转移的诊断,衍生的标志物包括表信号脂肪分数和质子密度脂肪分数,均能反映骨髓脂肪含量。目前,对于骨髓脂肪在骨转移瘤发生中的作用已经成为了人们关注的新焦点。目的:现就骨髓脂肪对骨转移的影响及磁共振成像定量评估技术进行综述,归纳比较不同磁共振脂肪定量技术评估骨转移的优劣势以及临床应用情况。方法:应用计算机在PubMed和中国知网数据库检索相关文献,英文检索词为“bone metastases,bone marrow adipocytes,magnetic resonance imaging,quantitative MRI,fat fraction,magnetic resonance spectrum,chemical shift encoding-based water–fat imaging”,中文检索词为“骨转移,骨髓脂肪,磁共振成像,定量磁共振成像,脂肪分数,磁共振波谱成像,基于化学移位编码的水脂肪成像”,根据纳入和排除标准共获得相关文献67篇。结果与结论:(1)骨髓脂肪细胞能通过分泌多种相关激素及细胞因子、为肿瘤细胞提供能量、诱导破骨细胞分化等多种途径协助骨转移的发生;(2)磁共振定量技术能够精确地定量脂肪组织,测量骨髓中脂肪含量的变化有助于骨转移的诊断;(3)磁共振波谱成像能够通过不同质子的进动频率反映不同的代谢产物,因此可用于脂肪定量,是目前用于评估转移性骨折的一种辅助检查手段;(4)基于化学移位编码的水脂肪成像可以使水和脂肪信号得以在正相位和反相位相分离,从而测量脂肪组织的信号,在鉴别椎体良恶性骨折方面具有较高的敏感性、特异性和准确性。BACKGROUND:The accurate diagnosis of early bone metastases plays an important role in treatment and prognosis.Bone biopsy is the gold standard for the diagnosis of bone metastases,but it is difficult to implement in clinical practice because of its invasive and small specimen size.In recent years,with the continuous development of magnetic resonance imaging technology,quantitative magnetic resonance imaging techniques such as magnetic resonance spectroscopy and based on chemical shift encoded magnetic resonance imaging have been widely used in the diagnosis of bone metastasis.The derived markers include table signal fat fraction and proton density fat fraction.All of them could reflect the bone marrow fat content.At present,the role of bone marrow fat in the development of bone metastases has become a new focus of attention.OBJECTIVE:To review the effect of bone marrow fat on bone metastasis and the quantitative evaluation techniques of magnetic resonance imaging,to summarize and compare the advantages and disadvantages of different magnetic resonance imaging fat quantification techniques in evaluating bone metastasis and their clinical applications.METHODS:The computer was used to search relevant literature in PubMed and CNKI database.Chinese and English search terms were “bone metastases,bone marrow adipocytes,magnetic resonance imaging,quantitative MRI,fat fraction,magnetic resonance spectrum,chemical shift encoding-based water–fat imaging.” A total of 67 relevant articles were obtained according to the inclusion and exclusion criteria.RESULTS AND CONCLUSION:(1) Bone marrow adipocytes can contribute to the occurrence of bone metastasis by secreting a variety of related hormones and cytokines,providing energy for tumor cells,and inducing osteoclast differentiation.(2) Quantitative magnetic resonance imaging can accurately quantify adipose tissue and measure the change of fat content in bone marrow,which is helpful for the diagnosis of bone metastasis.(3) Magnetic resonance spectroscopy can reflect differe

关 键 词：骨转移 骨髓脂肪 磁共振成像 磁共振波谱成像 基于化学移位编码的水脂肪成像 综述 

分 类 号：R445.2[医药卫生—影像医学与核医学] R318[医药卫生—诊断学] R730[医药卫生—临床医学]