Division of Musculoskeletal Radiology, Department of Radiology, Ajou University School of Medicine, 164, World cup-ro, Yeongtong-gu, Suwon, Gyeonggi-do, 16499, South Korea.
Musculoskeletal Imaging Laboratory, Ajou University Medical Center, Suwon, South Korea.
Eur Radiol. 2021 Jun;31(6):3582-3589. doi: 10.1007/s00330-020-07529-7. Epub 2020 Nov 27.
This study evaluated the diagnostic performance of the proton density fat fraction (PDFF) in predicting the progression of osteoporotic vertebral compression fractures (OVCFs).
The cohort in this retrospective study consisted of 48 patients with OVCFs who underwent spine MRI that included PDFF between December 2016 and June 2018. The patients were divided into two groups (with versus without OVCF progression, based on the radiographic results obtained at the 6-month follow-up examination). Two musculoskeletal radiologists independently calculated the PDFF of the fracture and the PDFF ratio (fracture PDFF/normal vertebrae PDFF) using regions of interest. The mean values of these parameters were compared between the two groups, and the receiver operating characteristic curves were analysed.
The mean age was significantly higher in the group with OVCF progression (71.6 ± 8.4 years) than in the group without (64.8 ± 10.5 years) (p = 0.018). According to reader 1, the PDFF ratio was significantly lower in the group with OVCF progression versus that without OVCF progression (0.38 ± 0.13 vs 0.51 ± 0.20; p = 0.009), whereas the difference in the PDFF itself was not statistically significant. The PDFF ratio [area under the curve (AUC) = 0.723; 95% confidence interval (CI), 0.575-0.842] had a larger AUC than did the PDFF (AUC = 0.667; 95% CI, 0.516-0.796). The optimal cut-off value of the PDFF ratio for predicting OVCF progression was 0.42; this threshold corresponded to sensitivity, specificity, and accuracy values of 84.0%, 60.9%, and 72.9%, respectively.
The age and PDFF ratio can be used to predict OVCF progression.
• Chemical shift-encoded magnetic resonance imaging provides quantitative parameters for predicting OVCF progression. • The PDFF ratio is significantly lower in patients with OVCF progression. • The PDFF ratio is superior to the PDFF for predicting OVCF progression.
本研究评估质子密度脂肪分数（PDFF）在预测骨质疏松性椎体压缩性骨折（OVCF）进展中的诊断性能。
本回顾性研究纳入了 2016 年 12 月至 2018 年 6 月间接受脊柱 MRI 检查的 48 例 OVCF 患者，这些患者的 MRI 检查中包含 PDFF。患者被分为两组（骨折进展组和无骨折进展组，根据 6 个月随访检查的影像学结果确定）。两位肌肉骨骼放射科医生使用感兴趣区域独立计算骨折的 PDFF 和 PDFF 比值（骨折 PDFF/正常椎体 PDFF）。比较两组之间这些参数的平均值，并对受试者工作特征曲线进行分析。
与无 OVCF 进展组相比，有 OVCF 进展组的平均年龄明显更高（71.6±8.4 岁 vs. 64.8±10.5 岁，p=0.018）。根据读者 1 的结果，有 OVCF 进展组的 PDFF 比值明显低于无 OVCF 进展组（0.38±0.13 比 0.51±0.20；p=0.009），而 PDFF 本身的差异无统计学意义。PDFF 比值（曲线下面积（AUC）=0.723；95%置信区间（CI），0.575-0.842）的 AUC 大于 PDFF（AUC=0.667；95%CI，0.516-0.796）。预测 OVCF 进展的 PDFF 比值最佳截断值为 0.42，此时的敏感性、特异性和准确性分别为 84.0%、60.9%和 72.9%。
年龄和 PDFF 比值可用于预测 OVCF 进展。
• 化学位移编码磁共振成像为预测 OVCF 进展提供了定量参数。
• 有 OVCF 进展的患者 PDFF 比值明显更低。
• PDFF 比值在预测 OVCF 进展方面优于 PDFF。
