Department of Radiology, Research Institute of Radiological Science, and Center for Clinical Imaging Data Science (CCIDS), Yonsei University College of Medicine, 50-1 Yonsei-Ro, Seodaemun-Gu, Seoul, 03722, South Korea.
Department of Biostatistics and Computing, Yonsei University Graduate School, Seoul, South Korea.
Radiol Med. 2023 Aug;128(8):970-977. doi: 10.1007/s11547-023-01662-1. Epub 2023 Jun 19.
This study aimed to evaluate whether quantitative water fraction parameters could predict fracture age in patients with benign vertebral compression fractures (VCFs).
A total of 38 thoracolumbar VCFs in 27 patients imaged using modified Dixon sequences for water fraction quantification on 3-T MRI were retrospectively reviewed. To calculate quantitative parameters, a radiologist independently measured the regions of interest in the bone marrow edema (BME) of the fractures. Furthermore, five features (BME, trabecular fracture line, condensation band, cortical or end plate fracture line, and paravertebral soft-tissue change) were analyzed. The fracture age was evaluated based on clear-onset symptoms and previously available images. A correlation analysis between the fracture age and water fraction was evaluated using a linear regression model, and a multivariable analysis of the dichotomized fracture age model was performed.
The water fraction ratio was the only significant factor and was negatively correlated with the fracture age of VCFs in multiple linear regression (p = 0.047), whereas the water fraction was not significantly correlated (p = 0.052). Water fraction and water fraction ratio were significant factors in differentiating the fracture age of 1 year in multiple logistic regression (odds ratio 0.894, p = 0.003 and odds ratio 0.986, p = 0.019, respectively). Using a cutoff of 0.524 for the water fraction, the area under the curve, sensitivity, and specificity were 0.857, 85.7%, and 87.1%, respectively.
Water fraction is a good imaging biomarker for the fracture healing process. The water fraction ratio of the compression fractures can be used to predict the fracture age of benign VCFs.
本研究旨在评估定量水分数参数是否可预测良性椎体压缩性骨折（VCF）患者的骨折年龄。
回顾性分析了 27 例患者的 38 个胸腰椎 VCF，这些患者在 3T MRI 上使用改良 Dixon 序列进行了水分数定量成像。为了计算定量参数，放射科医生在骨折的骨髓水肿（BME）中独立测量感兴趣区域。此外，分析了五个特征（BME、小梁骨折线、浓缩带、皮质或终板骨折线和椎旁软组织改变）。骨折年龄根据明确发作的症状和先前可用的图像进行评估。使用线性回归模型评估骨折年龄与水分数之间的相关性，并对骨折年龄的二分类模型进行多变量分析。
水分数比是唯一具有统计学意义的因素，与 VCF 骨折年龄在多元线性回归中呈负相关（p=0.047），而水分数与骨折年龄无显著相关性（p=0.052）。水分数和水分数比是区分 1 年骨折年龄的多变量逻辑回归中的显著因素（比值比 0.894，p=0.003 和比值比 0.986，p=0.019）。使用水分数的截断值为 0.524，曲线下面积、敏感性和特异性分别为 0.857、85.7%和 87.1%。
水分数是骨折愈合过程的良好成像生物标志物。压缩性骨折的水分数比可用于预测良性 VCF 的骨折年龄。
