Department of Diagnostic and Interventional Radiology, University Medical Center Freiburg, Faculty of Medicine, University of Freiburg, Hugstetter Strasse 55, 79106, Freiburg, Germany.
Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Oberschleißheim, Germany.
Eur Radiol. 2023 Mar;33(3):1501-1512. doi: 10.1007/s00330-022-09140-4. Epub 2022 Oct 14.
To assess the association of lumbar bone marrow adipose tissue fat fraction (BMAT-FF) and paraspinal muscle proton density fat fraction (PDFF) and their interplay with intervertebral disc degeneration (IVDD).
In this retrospective cross-sectional study based on a prospective population-based cohort, BMAT-FF and PDFF of asymptomatic individuals were calculated based on 3T-MRI dual-echo and multi-echo Dixon VIBE sequences. IVDD was assessed at motion segments L1 to L5 and dichotomized based on Pfirrmann grade ≥ 4 and/or presence of other severe degenerative changes or spinal abnormalities at least at one segment. Pearson's correlation coefficients were calculated for BMAT-FF and PDFF. Univariable and multivariable logistic regression models for IVDD were calculated.
Among 335 participants (mean age: 56.2 ± 9.0 years, 43.3% female), the average BMI was 27.7 ± 4.5 kg/m and the prevalence of IVDD was high (69.9%). BMAT-FF and PDFF were significantly correlated (r = 0.31-0.34; p < 0.001). The risk for IVDD increased with higher PDFF (OR = 1.45; CI 1.03, 2.04) and BMAT-FF (OR = 1.56; CI 1.16, 2.11). Pairwise combinations of PDFF and BMAT-FF quartiles revealed a lower risk for IVDD in individuals in the lowest BMAT-FF and PDFF quartile (OR = 0.21; CI 0.1, 0.48). Individuals in the highest BMAT-FF and PDFF quartile showed an increased risk for IVDD (OR = 5.12; CI 1.17, 22.34) CONCLUSION: Lumbar BMAT-FF and paraspinal muscle PDFF are correlated and represent both independent and additive risk factors for IVDD. Quantitative MRI measurements of paraspinal myosteatosis and vertebral bone marrow fatty infiltration may serve as imaging biomarkers to assess the individual risk for IVDD.
• Fat composition of the lumbar vertebral bone marrow is positively correlated with paraspinal skeletal muscle fat. • Higher fat-fractions of lumbar vertebral bone marrow and paraspinal muscle are both independent as well as additive risk factors for intervertebral disc degeneration. • Quantitative magnetic resonance imaging measurements of bone marrow and paraspinal muscle may serve as imaging biomarkers for intervertebral disc degeneration.
评估腰椎骨髓脂肪组织分数（BMAT-FF）和脊柱旁肌肉质子密度脂肪分数（PDFF）与椎间盘退变（IVDD）的相关性及其相互作用。
本研究基于前瞻性人群队列的回顾性横断面研究，使用 3T-MRI 双回波和多回波 Dixon VIBE 序列计算无症状个体的 BMAT-FF 和 PDFF。在 L1 至 L5 运动节段评估 IVDD，并根据 Pfirrmann 分级≥4 以及至少一个节段存在其他严重退行性改变或脊柱异常将其分为两部分。计算 BMAT-FF 和 PDFF 的 Pearson 相关系数。计算 IVDD 的单变量和多变量逻辑回归模型。
在 335 名参与者中（平均年龄：56.2±9.0 岁，43.3%为女性），平均 BMI 为 27.7±4.5kg/m2，IVDD 的患病率较高（69.9%）。BMAT-FF 和 PDFF 呈显著相关性（r=0.31-0.34；p<0.001）。较高的 PDFF（OR=1.45；CI 1.03，2.04）和 BMAT-FF（OR=1.56；CI 1.16，2.11）与 IVDD 风险增加相关。PDFF 和 BMAT-FF 四分位数的两两组合显示，最低四分位数的 BMAT-FF 和 PDFF 的个体 IVDD 风险较低（OR=0.21；CI 0.1，0.48）。最高四分位数的 BMAT-FF 和 PDFF 的个体 IVDD 风险增加（OR=5.12；CI 1.17，22.34）。
腰椎骨髓脂肪组织的脂肪含量与脊柱旁骨骼肌脂肪含量呈正相关，是 IVDD 的独立且附加的危险因素。脊柱旁肌脂肪增多和骨髓脂肪浸润的定量 MRI 测量可能是评估 IVDD 个体风险的影像学标志物。
腰椎骨髓的脂肪成分与脊柱旁骨骼肌肉的脂肪呈正相关。
较高的腰椎骨髓和脊柱旁肌肉脂肪分数均为椎间盘退变的独立且附加的危险因素。
骨髓和脊柱旁肌肉的定量磁共振成像测量可作为椎间盘退变的影像学标志物。
