■一项前瞻性研究。
■使用新的磁共振成像(MRI)基于F-和W-评分评估第一骶椎上的脂肪-水样组织变化,并评估其在骨质疏松症检测中的诊断性能。
■使用异常先进的MRI技术,以前的研究发现,脂肪-水的变化与骨质疏松症是一致的。常规MRI序列的作用可以在这方面扩展。S1椎骨被认为是脊柱手术中的关键解剖部位,因为它很少发生骨折。因此,S1可以表明骨质疏松性脂肪-水的变化。
■42名女性志愿者(年龄62.3±6.3岁)在伦理批准后接受了MRI(包括体模)和双能X射线吸收法(DXA)的脊柱检查。通过在T1和T2加权成像上通过椰子油和体模的水SI对S1椎体信号强度(SI)进行归一化来定义基于MRI体模的F-和W-scoreS1。分别。利用接收机工作特性分析,针对用DXA(DXA-aBMD)测量的标准面骨矿物质密度,研究了新评分对骨质疏松和椎体骨折的诊断性能.
■骨质疏松症患者的F-scoreS1和W-scoreS1比没有骨质疏松症的患者(分别为3.25和1.92)更大(分别为4.11和2.43),曲线下面积(AUC)为0.82和0.76(p<0.05),分别,用于骨质疏松症检测。同样,椎体骨折患者的平均F-scoreS1和W-scoreS1(分别为4.11和2.63)高于无骨折患者(分别为3.30和1.82),并且AUC(W-scoreS1为0.90,F-scoreS1为0.74)高于DXA-aBMD(AUC,0.26;p<0.03)。此外,F-和W-scoreS1表现出强相关性(r=0.65,p<0.001)。
■开发了新的基于S1椎体的MRI评分,以检测骨质疏松的变化,并证明在区分椎体骨折患者方面优于DXA-aBMD。
METHODS: A prospective study.
OBJECTIVE: To assess fat-water-like tissue changes on the 1st sacral vertebra using novel magnetic resonance imaging (MRI) phantombased F- and W-scores and evaluate their diagnostic performances in osteoporosis detection.
BACKGROUND: Using an uncommonly advanced MRI technique, previous studies have found that fat-water changes were consistent with osteoporosis. The role of routine MRI sequences can be extended in this regard. The S1 vertebra is considered a crucial anatomical site in spine surgeries because it seldom suffers from fractures. Thus, S1 could indicate osteoporotic fat-water changes.
METHODS: Forty-two female volunteers (aged 62.3±6.3 years) underwent spine examination with both MRI (including a
phantom) and dual-energy X-ray absorptiometry (DXA) following ethical approval. MRI
phantom-based F- and W-scoreS1 were defined by normalizing S1 vertebral signal intensities (SIs) by coconut oil and water SIs of the
phantom on T1- and T2-weighted imaging, respectively. Using receiver operating characteristic analysis, the diagnostic performances of the new scores for evaluating osteoporosis and vertebral fractures were investigated against standard areal bone mineral density measured with DXA (DXA-aBMD).
RESULTS: The F-scoreS1 and W-scoreS1 were greater (4.11 and 2.43, respectively) in patients with osteoporosis than those without osteoporosis (3.25 and 1.92, respectively) and achieved areas under the curve (AUCs) of 0.82 and 0.76 (p<0.05), respectively, for osteoporosis detection. Similarly, the mean F-scoreS1 and W-scoreS1 were higher (4.11 and 2.63, respectively) in patients with vertebral fractures than in those without fractures (3.30 and 1.82, respectively) and had greater AUCs (0.90 for W-scoreS1 and 0.74 for F-scoreS1) than DXA-aBMD (AUC, 0.26; p<0.03). In addition, the F- and W-scoreS1 demonstrated a strong correlation (r=0.65, p<0.001).
CONCLUSIONS: The new S1 vertebral-based MRI scores were developed to detect osteoporotic changes and demonstrated improvements over DXA-aBMD in differentiating patients with vertebral fractures.