Department of Radiology, Wan Fang Hospital, Taipei Medical University, 111 Hsing-Long Road, Sec 3, Taipei, 116, Taiwan.
Department of Radiology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
Eur Radiol. 2019 Sep;29(9):4999-5006. doi: 10.1007/s00330-019-06034-w. Epub 2019 Mar 7.
To investigate the relationship between paraspinal and psoas muscle volumes and acute osteoporotic or low-bone-mass compression fractures of the lumbar spine in postmenopausal women.
Patient data were retrieved retrospectively for postmenopausal women with L-spine magnetic resonance imaging (MRI) and dual-energy X-ray absorptiometry showing osteoporosis/low bone mass. Group 1 comprised eight women aged 60-80 years with MRI showing a single acute compression fracture. The age-matched group 2a (N = 12) and younger group 2b (N = 12) comprised of women whose MRIs showed no fractures. Cross-sectional MRIs of the paraspinal and psoas muscles and intramuscular fat volume for each muscle group were measured. Operator repeatability and reproducibility were obtained.
Group 1 showed significantly smaller lean muscle volume for all muscle groups at L5/S1. Intramuscular fat volume was also smaller in most muscle groups in group 1, though only reaching statistical significance at variable muscle groups and levels. Measurements show both good intrarater repeatability and interrater reproducibility of lean muscle volume estimations (intraclass correlation coefficient (ICC), 0.999 for rater A and 0.997 for rater B; Cronbach's alpha 0.995) and intramuscular fat volume estimations (ICC, 0.995 for rater A and 0.982 for rater B; Cronbach's alpha was 0.981).
This study provides the first quantitative evidence that compression fractures in postmenopausal women with underlying osteoporosis/low bone mass are associated with less paraspinal and psoas muscle volumes. Further longitudinal studies with larger cohorts are needed to verify this relationship.
• The risk of osteoporotic compression fractures is higher in older women with smaller paraspinal muscle volume. • Older women show smaller paraspinal muscle volume and more intramuscular fat compared to younger controls.
探讨绝经后女性脊柱旁和腰大肌体积与急性骨质疏松或低骨量性腰椎压缩性骨折的关系。
回顾性检索绝经后女性的 L 脊柱磁共振成像（MRI）和双能 X 线吸收法（DXA）数据，显示骨质疏松/低骨量。第 1 组包括 8 名年龄在 60-80 岁之间的女性，MRI 显示单一急性压缩性骨折。年龄匹配的第 2a 组（n=12）和较年轻的第 2b 组（n=12）由 MRI 无骨折的女性组成。测量每组脊柱旁和腰大肌的横断 MRI 以及肌肉内脂肪量。获得操作者的重复性和再现性。
第 1 组在 L5/S1 所有肌肉群的瘦肌肉体积均显著较小。第 1 组大多数肌肉群的肌肉内脂肪量也较小，尽管仅在不同肌肉群和水平达到统计学意义。测量结果显示瘦肌肉体积估计的内部观察者重复性和外部观察者再现性均较好（内部观察者相关系数（ICC），A 评分者为 0.999，B 评分者为 0.997；Cronbach's alpha 为 0.995）和肌肉内脂肪量估计（ICC，A 评分者为 0.995，B 评分者为 0.982；Cronbach's alpha 为 0.981）。
本研究首次提供了定量证据，表明骨质疏松/低骨量绝经后女性的压缩性骨折与脊柱旁和腰大肌体积较小有关。需要进一步进行更大队列的纵向研究来验证这种关系。
脊柱旁肌肉体积较小的老年女性骨质疏松性压缩性骨折风险更高。
与年轻对照组相比，老年女性的脊柱旁肌肉体积较小，肌肉内脂肪较多。
