Objective:To explore the iterative decomposition of water and fat with echo asymmetry and least-squares estimation quantitation sequence(IDEAL-IQ)in the diagnosis of primary osteoporosis using the least squares estimation method of 3.0T magnetic resonance asymmetric echoes.Methods:80 hospitalized orthopedic patients in our hospital from January 2022 to December 2023 were selected,all of whom underwent dual energy X-ray bone density examination and 3.0T magnetic resonance IDEAL-IQ technology examination.They were divided into normal bone mass group,decreased bone mass group,and osteoporosis group based on different bone density examination results.The detection of FF value in IDEAL-IQ was compared,and the correlation between FF value and bone mass was analyzed.Results:The results showed that the FF value level in the osteoporosis group was higher than that in the normal bone mass group and the decreased bone mass group(P<0.05),while the FF value level in the decreased bone mass group was similar to that in the normal bone mass group(P>0.05);The FF value was significantly negatively correlated with the results of dual energy X-ray bone density examination(r=-0.611,P<0.001);The receiver operating curve(ROC)analysis showed that the area under the diagnostic curve(AUC)of FF for primary osteoporosis was 0.831,the optimal diagnostic cutoffvalue was 76.63,and the sensitivity and specificity were 71.43%and 96.34%,respectively.Conclusion:In the diagnosis of primary osteoporosis patients,the FF value of 3.0T magnetic resonance IDEAL-IQ results is negatively correlated with their bone density level.ROC curve analysis of FF value has good diagnostic efficacy for this disease.