基于MRI的骨质疏松椎体压缩骨折患者椎旁肌特征定量分析研究  

MRI-based quantitative analysis of paraspinal muscle characteristics in patients with osteoporotic vertebral compression fractures

作　　者：陈泽正 王方永[1,2,3] 张文捷 尹浩然 CHEN Zezheng;WANG Fangyong;ZHANG Wenjie(Capital Medical University School of Rehabilitation Medicine,Beijing,100069,China;Beijing Bo′ai Hospital,China Rehabilitation Research Center,Beijing,100069,China;University of Health and Rehabilitation Sciences,Qingdao,266555,China)

机构地区：[1]首都医科大学康复医学院,北京市100069 [2]中国康复研究中心北京博爱医院脊柱脊髓外科,北京市100069 [3]康复大学,青岛市266555

出　　处：《中国脊柱脊髓杂志》2024年第6期595-601,619,共8页Chinese Journal of Spine and Spinal Cord

基　　金：首都卫生科研发展专项(No.CFH 2022-2-6013)。

摘　　要：目的:对比分析骨质疏松性椎体压缩性骨折(osteoporotic vertebral compression fracture,OVCF)患者和非OVCF患者腰椎MRI特征,脂肪浸润率(fatty infiltration,FI),探讨其与骨折发生的关系。方法:回顾性分析46例OVCF患者(70.67±11.99岁;男11例,女35例)的临床资料,以46例年龄(70.76±5.40岁)、性别(男11例,女35例)匹配的不伴OVCF的患者作为对照组。在腰椎MRI上测量椎旁肌FI、肌肉横截面积(cross-sectional area,CSA)和椎体骨质量(vertebral bone quality,VBQ)评分。采用独立样本t检验比较OVCF组与对照组之间的差异,并进行回归分析,探索OVCF发生的风险因素。结果:OVCF组患者的VBQ评分显著高于对照组(P<0.05),椎旁肌FI显著高于对照组(P<0.05)。两组椎旁肌CSA无显著差异。VBQ评分(OR=1.963,P<0.01)和L4代表的椎旁肌FI(OR=1.203,P<0.01)是OVCF的独立风险因素。结论:OVCF患者的腰椎MRI参数与非OVCF的骨质疏松患者相比,VBQ评分及椎旁肌FI均较大,VBQ评分、椎旁肌FI是OVCF的独立风险因素,预防OVCF同时应重视对椎旁肌功能的改善。Objectives:To compare and analyze the MRI characteristics and fatty infiltration(FI)of the lumbar spine in patients with and without osteoporotic vertebral compression fracture(OVCF)to explore their relationships with fracture.Methods:46 patients with OVCF(70.67±11.99 years old;11 males,35 famales)were retrospectively analyzed,and 46 age-(70.76±5.40)and sex-(11 males,35 famales)matched osteoporotic patients without OVCF were taken as the control group.Paravertebral muscle FI,cross-sectional area(CSA),and vertebral bone quality(VBQ)score were measured on lumbar MRI.Independent samples t-test was used to compare the differences between the OVCF group and the control group,and regression analysis was performed to explore the risk factors for the development of OVCF.Results:Patients in the OVCF group had significantly higher VBQ scores(P<0.05)and significantly higher paravertebral muscle FI(P<0.05)than those in the control group.There was no significant difference in CSA of paravertebral muscles between the two groups.VBQ score(OR=1.963,P<0.01)and FI of paravertebral muscles represented by L4(OR=1.203,P<0.01)were the independent risk factors for OVCF.Conclusions:The MRI parameters of lumbar spine in patients with OVCF had greater VBQ scores and paravertebral muscle FI compared with the osteoporotic patients without OVCF;VBQ scores and paravertebral muscle FI are the independent risk factors for OVCF,and attentions should be paid to improve paravertebral muscle functions in the meantime of preventing OVCF.

关 键 词：骨质疏松性椎体压缩骨折 脊柱椎旁肌肉 脂肪浸润率 椎体骨质量评分 磁共振成像 

分 类 号：R683.2[医药卫生—骨科学] R445.2[医药卫生—外科学]