基于MRI的骨质量评分系统及其临床应用研究进展  

Advances in MRI-based bone quality scoring systems and their clinical applications

作　　者：王健之 汪雷[1] 宋跃明[1] WANG Jianzhi;WANG Lei;SONG Yueming(Department of Orthopedics,West China Hospital,Sichuan University,Chengdu Sichuan,610041,P.R.China)

机构地区：[1]四川大学华西医院骨科,成都610041

出　　处：《中国修复重建外科杂志》2025年第3期370-374,共5页Chinese Journal of Reparative and Reconstructive Surgery

摘　　要：目的综述基于MRI的骨质量评分系统及其临床应用研究进展。方法广泛查阅近年国内外基于MRI的骨质量评分系统相关研究,从测量方法、影响因素、临床意义等方面进行总结。结果骨质疏松症在我国发病率较高,影响患者生活质量、相关骨科手术效果,早期识别骨质疏松症具有重要临床意义。近年来,基于MRI的骨质量评分系统不断丰富,包括椎体骨质量评分、终板骨质量评分、椎弓根骨质量评分。相较于骨密度测量“金标准”的双能X线吸收测定法,骨质量评分系统在识别骨量异常、预测术后相关并发症等方面均有较好效能,且不易受腰椎退行性病变的影响。结论基于MRI的骨质量评分系统具有较高的临床应用价值,但目前研究多为回顾性队列和病例对照研究,存在偏倚风险,临床应用价值需要更多荟萃分析、大样本前瞻性研究进一步明确。Objective To summarize the advances in MRI-based bone quality scoring systems and their clinical applications.Methods A comprehensive literature review was conducted on recent studies related to the MRI-based bone quality scoring system,focusing on measurement methods,influencing factors,and clinical significance.Results Osteoporosis has a high incidence in China,significantly impacting patients’quality of life and the postoperative outcomes of related orthopedic surgeries.Early identification of osteoporosis holds important clinical significance.In recent years,both domestic and international research has enriched the MRI-based bone quality scoring systems,which includes vertebral bone quality scoring,endplate bone quality scoring,and pedicle bone quality scoring.Compared to the“gold standard”of bone density measurement,dual-energy X-ray absorptiometry,the bone quality scoring systems demonstrate good efficacy in identifying abnormal bone mass and predicting postoperative complications,while being less influenced by degenerative changes in the lumbar spine,indicating its important clinical application value.Conclusion The MRI-based bone quality scoring systems have good value in clinical applications.However,current studies are mostly retrospective cohort and case-control studies,which carry a risk of bias.The clinical application value needs further clarification through meta-analysis and large-scale prospective studies.

关 键 词：MRI 骨质量评分系统 骨质疏松症 骨密度 

分 类 号：R580[医药卫生—内分泌] R445.2[医药卫生—内科学]