Zhu Hui-Ling, Ding Jian-Ping, Qi Ying-Jie
Department of Radiology, the Affiliated Hospital of Hangzhou Normal University, Hangzhou 310015, Zhejiang, China.
Zhongguo Gu Shang. 2021 Aug 25;34(8):743-9. doi: 10.12200/j.issn.1003-0034.2021.08.010.
To investigate the application value of apparent diffusion coefficient (ADC) and signal intensity ratio (SIR) of MR diffusion-weighted imaging (DWI) in quantitative evaluation of lumbar spine osteoporosis.
A total of 175 patients with lumbar spine diseases who received dualenergy X-ray absorption (DXA) bone mineral density (BMD), routine MRI and DWI of the lumbar spine from May 2017 to October 2019 were selected. According to the T-value of DXA, the patients were divided into osteoporosis group (64 cases), osteopenia group (53 cases) and normal bone mass group (58 cases). The ADC and SIR values of L-L were measured and compared among the three groups and the correlation between ADC, SIR and BMD was analyzed. The ROC curve was used to evaluate the differential diagnosis value of ADC and SIR for osteoporosis, osteopenia and normal bone mass.
There were statistically significant differences in ADC and SIR values among three groups (=41.386, 37.114, all =0.000). The ADC value of the osteoporosis group was lower than that of the osteopenia group and the normal bone mass group, and the difference was statistically significant (=3.540, 9.069, =0.001, 0.000);the SIR value of the osteoporosis group was higher than that of the osteopenia group and the normal bone mass group, and the difference was statistically significant (=5.083, 8.523, all =0.000). Spearman correlation analysis showed that ADC value was positively correlated with BMD (=0.313, =0.004);SIR value was negatively correlated with BMD (=- 0.589, =0.000). Receiver operator characteristic (ROC) curve analysis showed that the area under curve (AUC), sensitivity andspecificity of ADC and SIR in the diagnosis of lumbar osteoporosis and osteopenia were 0.742, 89.1% , 52.8% and 0.729, 89.1%, 50.9% respectively (=0.000);the AUC, sensitivity and specificity of ADC and SIR in the diagnosis of lumbar osteoporosis and normal bone mass were 0.815, 100.0%, 50.0% and 0.856, 65.6%, 93.1%, respectively (=0.000);the AUC, sensitivity and specificity of ADC and SIR in the diagnosis of lumbar osteoporosis were 0.78, 89.1%, 51.4% and 0.795, 50.0% and 94.6% respectively (=0.000);All have a certain diagnostic value.
ADC and SIR can better reflect the BMD of patients with lumbar diseases, and can quantitatively evaluate the vertebral body of osteoporosis, which play an important role in the diagnosis of lumbar osteoporosis.
探讨磁共振扩散加权成像（DWI）的表观扩散系数（ADC）及信号强度比（SIR）在腰椎骨质疏松症定量评估中的应用价值。
选取2017年5月至2019年10月期间接受腰椎双能X线吸收法（DXA）骨密度（BMD）、常规MRI及DWI检查的175例腰椎疾病患者。根据DXA的T值，将患者分为骨质疏松组（64例）、骨量减少组（53例）和骨量正常组（58例）。测量并比较三组L-L的ADC及SIR值，分析ADC、SIR与BMD之间的相关性。采用ROC曲线评估ADC及SIR对骨质疏松、骨量减少和骨量正常的鉴别诊断价值。
三组间ADC及SIR值差异有统计学意义（=41.386，37.114，均=0.000）。骨质疏松组的ADC值低于骨量减少组和骨量正常组，差异有统计学意义（=3.540，9.069，=0.001，0.000）；骨质疏松组的SIR值高于骨量减少组和骨量正常组，差异有统计学意义（=5.083，8.523，均=0.000）。Spearman相关性分析显示，ADC值与BMD呈正相关（=0.313，=0.004）；SIR值与BMD呈负相关（=-0.589，=0.000）。受试者工作特征（ROC）曲线分析显示，ADC及SIR诊断腰椎骨质疏松和骨量减少的曲线下面积（AUC）、敏感度和特异度分别为0.742、89.1%、52.8%和0.729、89.1%、50.9%（=0.000）；ADC及SIR诊断腰椎骨质疏松和骨量正常的AUC、敏感度和特异度分别为0.815、100.0%、50.0%和0.856、65.6%、93.1%（=0.000）；ADC及SIR诊断腰椎骨质疏松的AUC、敏感度和特异度分别为0.78、89.1%、51.4%和0.795、50.0%、94.6%（=0.000）；均具有一定的诊断价值。
ADC及SIR能较好地反映腰椎疾病患者的BMD，可对骨质疏松椎体进行定量评估，在腰椎骨质疏松症的诊断中具有重要作用。
