磁共振IDEAL-IQ序列评估椎旁肌肉脂肪含量联合钙磷乘积预测老年患者椎体压缩性骨折的价值  

Value of MRI IDEAL-IQ sequence in assessing the paravertebral muscle fat content plus calcium-phosphorus product in estimating vertebral compression fractures in elderly patients

作　　者：张楠楠 陈摇飞 汤摇地 任慧慧 孙碧云 袁玉山[3] ZHANG Nannan;CHEN Fei;TANG Di;REN Huihui;SUN Biyun;YUAN Yushan(CT/MR Department,Linquan County People′s Hospital,Linquan 236400,Anhui,China)

机构地区：[1]临泉县人民医院摇CT/MR室,安徽摇临泉摇236400 [2]皖南医学院第一附属医院弋矶山医院摇超声科,安徽摇芜湖241001 [3]阜阳市人民医院摇影像中心,安徽摇阜阳摇236000

出　　处：《皖南医学院学报》2025年第2期163-166,共4页Journal of Wannan Medical College

基　　金：阜阳市卫生健康科研立项课题(FY2021-139,FY2023-087)。

摘　　要：目的:探讨基于磁共振IDEAL-IQ序列评估椎旁肌肉改变联合钙磷乘积对预测老年患者椎体压缩性骨折的价值。方法:选取2023年4~12月在临泉县人民医院住院的老年椎体压缩性骨折患者83例为观察组,同期年龄、性别匹配的61例无椎体压缩性骨折患者为对照组,搜集入组病例临床、实验室检查资料,包括年龄、性别、有无高血压、有无糖尿病、白蛋白、尿素氮、血清肌酐、血清钙、血清磷,并计算钙磷乘积、校正血钙、校正钙磷乘积。所有病例均行磁共振IDEAL-IQ序列扫描腰椎,并测量L 3正中水平腰大肌、竖脊肌、多裂肌脂肪分数(FF)。结果:观察组血清钙、血清磷、钙磷乘积、校正血钙、校正钙磷乘积水平均低于对照组(P<0.01),而腰大肌、竖脊肌、多裂肌FF值均高于对照组(P<0.05);Logistic回归分析显示校正钙磷乘积升高是老年患者椎体压缩性骨折的保护因素(P<0.01),竖脊肌FF、多裂肌FF增高是老年患者椎体压缩性骨折的危险因素(P<0.001);ROC曲线显示,校正钙磷乘积、竖脊肌FF、多裂肌FF预测老年患者椎体压缩性骨折的AUC分别为0.741、0.862、0.816,联合指标预测老年患者椎体压缩性骨折的AUC为0.936。结论:磁共振IDEAL-IQ序列评估椎旁肌肉改变联合钙磷乘积可以对老年患者椎体压缩性骨折进行较好的预测评估。Objective:To evaluate the value of paravertebral muscle changes combined with calcium-phosphorus product in estimating vertebral compression fractures in the elderly based on MRI IDEAL-IQ sequence.Methods:Eighty-three elderly hospitalized patients with vertebral compression fracture,treated in Linquan County People′s Hospital,were included from April to December of 2023 in the observational group,and another 61 patients without vertebral compression fracture,matched with similar age and genders and treated in the corresponding period,were included in the control group.Clinical and laboratory diagnostic findings of enrolled patients were collected,including the age,gender,presence or absence of hypertension and diabetes,levels of albumin,urea nitrogen,serum creatinine,serum calcium and phosphorus.The calcium and phosphorus products were calculated,and the blood calcium and phosphorus products were corrected.All patients underwent MR IDEAL-IQ sequence scan of lumbar spine,and the fat fraction(FF)of the median horizontal psoas as well as erectus and multifidus muscles was measured at L 3.The above data were analyzed statistically.Results:The levels of serum calcium,serum phosphorus,calcium-phosphorus product,corrected blood calcium and corrected calcium-phosphorus product were lower in observational group than in the control group(P<0.01),while the FF values of psoas major muscle,erector spine muscle and multifidus muscle were higher than those in control group(P<0.05).Bivariate logistic regression analysis showed that the increase of the corrected product of calcium and phosphorus was a protective factor for vertebral compression fractures in the elderly patients(P<0.01),whereas the increase of FF of erectus muscle and multifidus muscle was the risk factors for vertebral compression fractures in this group of patients(P<0.001).ROC curve showed that the AUC of corrected calci-phosphorus product,FF of vertical spine muscle and FF of multifidus muscle in predicting vertebral compression fractures in the elderly was

关 键 词：骨质疏松 压缩性骨折 椎旁肌肉 钙磷乘积 磁共振成像 

分 类 号：R445.2[医药卫生—影像医学与核医学] R687.3[医药卫生—诊断学] R589.5[医药卫生—临床医学]