目的 评估MRI集成(magnetic resonance image compilation,MAGiC)序列在原发性骨质疏松症中的应用价值.材料与方法 前瞻性招募2023年5月至2023年9月期间完成胸部低剂量CT检查的健康体检志愿者.所有志愿者均自愿接受常规腰椎MRI及MAGiC序列扫描.分别测量并计算基于胸部低剂量CT的腰椎平均骨密度(bone mineral density,BMD)值、基于常规T1WI椎体骨质量(vertebral bone quality,VBQ)值、基于MAGiC T1WI的VBQ(VBQ-magic)及平均T1 弛豫时间(average T1 relaxation time,T1av)值、平均T2弛豫时间(average T2 relaxation time,T2av)值、质子密度平均(average proton density,PDav)值以及身体质量指数(body mass index,BMI)值.按腰椎定量CT(quantitative computed tomography,QCT)骨质疏松诊断标准分为骨量正常组(63例)、骨量减少组(43例)及骨质疏松组(22例).多组间参数比较采用单因素方差分析或Kruskal-Wallis检验,两两比较采用LSD法检验或Wilcoxon检验,采用Pearson或Spearman相关系数分析年龄、VBQ、VBQ-magic、T1av、T2av、PDav与BMD的相关性,采用受试者工作特征(receiver operating characteristic,ROC)曲线评价单参数及联合参数对骨量减少及骨质疏松的诊断效能.结果 三组间年龄、VBQ、VBQ-magic、T1av、T2av、PDav值差异有统计学意义(P<0.05).骨量正常组、骨量减少组、骨质疏松组VBQ-magic值分别为 2.92(2.71,3.11)、3.16(2.87,3.40)、3.37(3.19,3.53),两两比较组间差异均有统计学意义(P≤0.009);T1av 值分别为 622.80(554.80,692.00)ms、565.40(538.00,599.20)ms、560.50(515.80,586.55)ms,骨量正常组与骨量减少组、骨质疏松组组间差异有统计学意义(P均=0.001);T2av值分别为(75.40±6.06)ms、(77.05±5.95)ms、(84.79±5.36)ms,骨量正常组、骨量减少组与骨质疏松组间差异有统计学意义(P均<0.001);骨量正常组PDav值小于骨量减少组及骨质疏松组(P=0.007、0.043).VBQ-magic、T1av与BMD值呈中等相关(r=-0.524、0.403);T2av、PDav与BMD值呈弱相关(r=-0.365、-0.224).VBQ-magic、T1av、VBQ-magic+T1av在区分骨量减少的曲线下面积(area under the curve,AUC)分别为0.772、0.702、0.782,VBQ-magic单独及联合T1av的诊断效能与VBQ间差异无统计学意义(P>0.05);VBQ-magic、T2av、VBQ-magic+T2av在区分骨质疏松的AUC分别为0.810、0.867、0.803,VBQ-magic单独及联合T2av的诊断效能与VBQ间差异无统计学意义(P>0.05).结论 基于MAGiC T1WI的VBQ评分及T1、T2值对骨量减少及骨质疏松具有一定的预测能力,可为骨质疏松症提供新的检测方法和参考指标.
Feasibility study of the MAGiC technique for quantitative assessment of primary osteoporosis
Objective:To evaluate the application value of magnetic resonance image compilation(MAGiC)sequence in primary osteoporosis.Materials and Methods:Prospectively recruited health screening volunteers who completed a low-dose chest CT scans between May 2023 and September 2023.All volunteers voluntarily underwent routine lumbar MRI and MAGiC sequence scans.The average bone mineral density(BMD)value of the lumbar spine based on low-dose chest CT,the VBQ value based on conventional T1-weighted imaging,and the VBQ-magic,average T1 relaxation time(T1av),average T2 relaxation time(T2av),average proton density(PDav)values based on MAGiC T1-weighted imaging were measured,and the body mass index(BMI)value was calculated.Patients were categorized into a normal bone group(63 cases),a bone loss group(43 cases),and an osteoporosis group(22 cases)based on the osteoporosis diagnostic criteria of lumbar quantitative computed tomography(QCT).Multiple group comparisons were performed using one-way ANOVA or Kruskal-Wallis test.Pairwise comparisons were conducted using either LSD test or Wilcoxon test.The correlations between each parameter and BMD were examined using Pearson or Spearman correlation analysis.Receiver operating characteristic(ROC)curves were employed to evaluate the diagnostic efficacy of single and combined parameters for bone loss and osteoporosis.Results:The differences in age,VBQ,VBQ-magic,T1av,T2av,and PDav values among the three groups were statistically significant(P<0.05).The VBQ-magic values for the normal bone group,bone loss group,and osteoporosis group were 2.92(2.71,3.11),3.16(2.87,3.40),and 3.37(3.19,3.53),respectively,the differences between each pair of groups were statistically significant(P≤0.009).The T1av values were 622.80(554.80,692.00)ms,565.40(538.00,599.20)ms,and 560.50(515.80,586.55)ms,respectively,the differences between the normal bone group and the bone loss group,as well as the osteoporosis group,were statistically significant(P=0.001 for both).The T2av values were(75.40±6.06)ms,(77.05±5.95)ms,and(84.79±5.36)ms,respectively,the differences among the normal bone group,bone loss group,and osteoporosis group were statistically significant(P<0.001 for both).The PDav value of the normal bone group was less than that of the bone loss group and osteoporosis group(P=0.007,0.043).There was a moderate correlation between VBQ-magic,T1av,and BMD values(r=-0.524,0.403),while T2av and PDav showed a weak correlation with BMD values(r=-0.365,-0.224).The areas under the curve(AUC)for VBQ-magic,T1av,and VBQ-magic+T1av in distinguishing bone loss were 0.772,0.702,and 0.782,respectively.The diagnostic efficacy of VBQ-magic alone and combined with T1av showed no statistically significant difference from VBQ(P>0.05).The AUCs for VBQ-magic,T2av,and VBQ-magic+T2av in distinguishing osteoporosis were 0.810,0.867,and 0.803,respectively.The diagnostic efficacy of VBQ-magic alone and combined with T2av showed no statistically significant difference from VBQ(P>0.05).Conclusions:The VBQ scoring based on MAGiC T1-weighted images and the T1 and T2 values have a certain predictive ability for bone loss and osteoporosis,providing new diagnostic methods and reference indices for osteoporosis.
osteoporosisvertebral bone qualitybone mineral densitymagnetic resonance imagingquantitative magnetic resonance imaging
国家科技期刊平台
NSTL
万方数据
维普
