背景：通过磁共振成像（MRI）对质子密度脂肪分数（PDFF）进行非侵入性评估可能会改善骨折的预测。
目的：这项工作旨在确定PDFF与骨折之间是否存在关联。
方法：在里尔大学医院进行了一项病例对照研究，里尔,法国,有两组绝经后妇女：一组最近有骨质疏松性骨折，另一个没有骨折.腰椎和股骨近端（股骨头，脖子,和骨干）使用基于化学位移的水脂分离MRI（WFI）和腰椎和髋部的双能X射线吸收法扫描确定PDFF。我们的主要目的是确定绝经后妇女腰椎PDFF与骨质疏松性骨折之间的关系。协方差分析用于比较患者病例（总体和根据骨折类型）和对照之间的PDFF测量值，在调整了年龄之后，Charlson合并症指数(CCI)和BMD。
结果：在199名参与者中，与患者病例(n=100)相比,对照组(n=99)明显年轻(P<.001),BMD(所有部位P<0.001)明显较高.共包括52例临床椎骨骨折和48例非椎骨骨折的妇女。当比较患者病例和对照组的PDFF时，调整后的年龄，CCI和BMD,两组间腰椎或股骨近端无统计学差异.当PDFF与临床椎体骨折（n=52）和对照组的比较，临床椎体骨折患者的股骨颈PDFF和股骨干PDFF均低于对照组(校正平均值[SE]79.3%[1.2]vs83.0%[0.8];P=0.020;77.7%[1.4]vs81.6%[0.9];P=0.029).
结论：骨质疏松性骨折患者和对照组之间腰椎PDFF无差异。然而,基于影像学的股骨近端PDFF可以区分有和没有临床椎体骨折的绝经后妇女，独立于年龄,CCI和BMD。
Noninvasive assessment of proton density fat fraction (PDFF) by magnetic resonance imaging (MRI) may improve the prediction of fractures.
This work aimed to determine if an association exists between PDFF and fractures.
A
case-control study was conducted at Lille University Hospital, Lille, France, with 2 groups of postmenopausal women: one with recent osteoporotic fractures, and the other with no fractures. Lumbar spine and proximal femur (femoral head, neck, and diaphysis) PDFF were determined using chemical shift-based water-fat separation MRI (WFI) and dual-energy x-ray absorptiometry scans of the lumbar spine and hip. Our primary objective was to determine the relationship between lumbar spine PDFF and osteoporotic fractures in postmenopausal women. Analysis of covariance was used to compare PDFF measurements between patient cases (overall and according to the type of fracture) and controls, after adjusting for age, Charlson comorbidity index (CCI) and BMD.
In 199 participants, controls (n = 99) were significantly younger (P < .001) and had significantly higher BMD (P < 0.001 for all sites) than patient cases (n = 100). A total of 52 women with clinical vertebral fractures and 48 with nonvertebral fractures were included. When PDFFs in patient cases and controls were compared, after adjustment on age, CCI, and BMD, no statistically significant differences between the groups were found at the lumbar spine or proximal femur. When PDFFs in participants with clinical vertebral fractures (n = 52) and controls were compared, femoral neck PDFF and femoral diaphysis PDFF were detected to be lower in participants with clinical vertebral fractures than in controls (adjusted mean [SE] 79.3% [1.2] vs 83.0% [0.8]; P = 0.020, and 77.7% [1.4] vs 81.6% [0.9]; P = 0.029, respectively).
No difference in lumbar spine PDFF was found between those with osteoporotic fractures and controls. However, imaging-based proximal femur PDFF may discriminate between postmenopausal women with and without clinical vertebral fractures, independently of age, CCI, and BMD.
