He Jie, Fang Hao, Na Li Xiao
1 Department of Radiology, The Third Hospital, Hebei Medical University, Hebei Province Biomechanical Key Laboratory of Orthopedics, Shijiazhuang, Hebei Province, PR China.
2 Department of Radiology, First Affiliated Hospital, Tianjin University of Chinese Medicine, PR China.
Acta Radiol. 2018 Jan;59(1):89-96. doi: 10.1177/0284185117704235. Epub 2017 Apr 14.
Background There has been controversy surrounding the relationship between diffusivity and bone mineral density (BMD) in vertebral bone marrow. Moreover, sex-related differences of vertebral bone marrow diffusivity in relation to varying bone densities have not yet been evaluated. Purpose To prospectively investigate the role of diffusion-weighted imaging (DWI) in assessing vertebral marrow changes in normal adults with varying bone densities. Material and Methods A total of 124 normal adult volunteers were enrolled in this study. Sagittal magnetic resonance (MR) DWI of the lumbar spine was performed. The ADC values of vertebral bone marrow were measured. Volumetric BMD measurement was performed by quantitative computed tomography (QCT) using Mindways QCT analysis software. All participants were divided into three groups according to BMD (normal, osteopenia, osteoporosis). The differences of the apparent diffusion coefficient (ADC) values of the three groups was compared, and partial correlation analysis was used to evaluate the correlation between ADC values and BMD. Results ADC values decreased as BMD decreased in female participants. When compared with the normal bone density group, ADC values were significantly decreased in the osteoporotic group and in the osteopenic group of female participants. ADC values of female participants were significantly higher than of male participants in the normal bone density group ( P < 0.001). ADC values correlated positively with BMD values (r = 0.307, P = 0.016) for female participants. Conclusion The diffusivity in vertebral bone marrow with varying bone densities differed by sex. ADC values correlated positively with BMD in women. DWI can quantitively evaluate osteoporosis in women.
围绕椎体骨髓扩散率与骨密度（BMD）之间的关系一直存在争议。此外，椎体骨髓扩散率与不同骨密度相关的性别差异尚未得到评估。目的：前瞻性研究扩散加权成像（DWI）在评估不同骨密度正常成年人椎体骨髓变化中的作用。材料与方法：本研究共纳入124名正常成年志愿者。对腰椎进行矢状面磁共振（MR）DWI检查。测量椎体骨髓的表观扩散系数（ADC）值。使用Mindways QCT分析软件通过定量计算机断层扫描（QCT）进行体积骨密度测量。所有参与者根据骨密度分为三组（正常、骨量减少、骨质疏松）。比较三组的ADC值差异，并采用偏相关分析评估ADC值与骨密度之间的相关性。结果：女性参与者中，ADC值随骨密度降低而降低。与正常骨密度组相比，女性参与者骨质疏松组和骨量减少组的ADC值显著降低。在正常骨密度组中，女性参与者的ADC值显著高于男性参与者（P < 0.001）。女性参与者的ADC值与骨密度值呈正相关（r = 0.307，P = 0.016）。结论：不同骨密度的椎体骨髓扩散率存在性别差异。女性的ADC值与骨密度呈正相关。DWI可定量评估女性骨质疏松症。
