腰椎骨质疏松症评估：骨小梁胶原结合水的定量磁共振成像。
Assessment of Osteoporosis in Lumbar Spine: Quantitative MR Imaging of Collagen Bound Water in Trabecular Bone.
机构信息
Department of Radiology, The Fifth Affiliated Hospital of Sun Yat-Sen University, Zhuhai, China.
Department of Spinal Surgery, The Fifth Affiliated Hospital of Sun Yat-Sen University, Zhuhai, China.
出版信息
Front Endocrinol (Lausanne). 2022 Feb 16;13:801930. doi: 10.3389/fendo.2022.801930. eCollection 2022.
AIM
Bone collagen matrix makes a crucial contribution to the mechanical properties of bone by imparting tensile strength and elasticity. The collagen content of bone is accessible quantification of collagen bound water (CBW) indirectly. We prospectively study the performance of the CBW proton density (CBWPD) measured by a 3D short repetition time adiabatic inversion recovery prepared ultrashort echo time (STAIR-UTE) magnetic resonance imaging (MRI) sequence in the diagnosis of osteoporosis in human lumbar spine.
METHODS
A total of 189 participants with a mean age of 56 (ranged from 50 to 86) years old were underwent MRI, quantitative computed tomography (QCT), and dual-energy X-ray absorptiometry (DXA) in lumbar spine. Major fracture risk was also evaluated for all participants using Fracture Risk Assessment Tool (FRAX). Lumbar CBWPD, bone marrow fat fraction (BMFF), bone mineral density (BMD) and T score values were calculated in three vertebrae (L2-L4) for each subject. Both the CBWPD and BMFF were correlated with BMD, T score, and FRAX score for comparison. The abilities of the CBWPD and BMFF to discriminate between three different cohorts, which included normal subjects, patients with osteopenia, and patients with osteoporosis, were also evaluated and compared using receiver operator characteristic (ROC) analysis.
RESULTS
The CBWPD showed strong correlation with standard BMD (R = 0.75, P < 0.001) and T score (R = 0.59, P < 0.001), as well as a moderate correlation with FRAX score (R = 0.48, P < 0.001). High area under the curve (AUC) values (≥ 0.84 using QCT as reference; ≥ 0.76 using DXA as reference) obtained from ROC analysis demonstrated that the CBWPD was capable of well differentiating between the three different subject cohorts. Moreover, the CBWPD had better correlations with BMD, T score, and FRAX score than BMFF, and also performed better in cohort discrimination.
CONCLUSION
The STAIR-UTE-measured CBWPD is a promising biomarker in the assessment of bone quality and fracture risk.
目的
骨胶原基质通过赋予拉伸强度和弹性，对骨的机械性能做出了至关重要的贡献。骨胶原的含量可以通过间接定量测量胶原结合水（CBW）来实现。我们前瞻性地研究了由三维短重复时间绝热反转恢复准备超短回波时间（STAIR-UTE）磁共振成像（MRI）序列测量的 CBW 质子密度（CBWPD）在人类腰椎骨质疏松症诊断中的性能。
方法
共纳入 189 名平均年龄为 56 岁（年龄范围为 50-86 岁）的参与者，对其进行了 MRI、定量计算机断层扫描（QCT）和双能 X 线吸收法（DXA）腰椎检查。对所有参与者还使用骨折风险评估工具（FRAX）评估了主要骨折风险。为每个受试者的三个椎体（L2-L4）计算了腰椎 CBWPD、骨髓脂肪分数（BMFF）、骨密度（BMD）和 T 评分值。比较了 CBWPD 和 BMFF 与 BMD、T 评分和 FRAX 评分的相关性。使用受试者工作特征（ROC）分析评估和比较了 CBWPD 和 BMFF 区分三个不同队列（包括正常受试者、骨质疏松症患者和骨质疏松症患者）的能力。
结果
CBWPD 与标准 BMD（R = 0.75，P < 0.001）和 T 评分（R = 0.59，P < 0.001）具有很强的相关性，与 FRAX 评分（R = 0.48，P < 0.001）也具有中度相关性。ROC 分析得到的高曲线下面积（AUC）值（以 QCT 为参考时≥0.84；以 DXA 为参考时≥0.76）表明，CBWPD 能够很好地区分三个不同的受试者队列。此外，CBWPD 与 BMD、T 评分和 FRAX 评分的相关性优于 BMFF，并且在队列区分方面表现更好。
结论
STAIR-UTE 测量的 CBWPD 是评估骨质量和骨折风险的有前途的生物标志物。
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