Naik Suprava, Jain Mantu, Bhoi Sanjeev Kumar, Tripathy Sujit
Department of Radiodiagnosis, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India.
Department of Orthopaedics, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India.
Indian J Radiol Imaging. 2023 Dec 4;34(2):239-245. doi: 10.1055/s-0043-1776883. eCollection 2024 Apr.
Osteoporosis is a common metabolic bone disease accounting for low back pain (LBP). It is diagnosed by dual-energy X-ray absorptiometry (DXA). Magnetic resonance imaging (MRI), a routine investigation for LBP, is also sensitive to detect fat fraction (FF) of the vertebral body that increases with increasing age. This study aimed to correlate vertebral marrow FF using MRI and bone mineral density (BMD). Patients presenting with low backache and suspected osteoporosis were included. All patients underwent an MRI of lumbosacral spine and DXA. Patients were categorized into an osteoporotic and a nonosteoporotic group based on the T-score obtained from DXA. "T-scores" of < -2.5 on BMD were considered as osteoporotic spine. T-score of > -2.5 was considered as nonosteoporotic. The FF obtained from the DIXON sequence of MRI was correlated between the two groups. Thirty-one patients were included with a mean age of 54.26 ± 11.6 years. Sixteen patients were osteoporotic based on the defined criteria in the methods. The mean vertebral marrow FF was significantly higher in the osteoporotic patients (64.98 ± 8.8%) compared with the nonosteoporotic (45.18 ± 13.2%) ( = 0.001). The mean FF of the vertebra having fracture (69.19 ± 7.73%) was significantly higher than that of patients without fracture (57.96 ± 5.75%) ( = 0.03). Taking a cutoff value of vertebral marrow FF of 54.85, the sensitivity and specificity of diagnosing osteoporosis were 93 and 80%, respectively, with a confidence interval of 95%. The area under the curve was 0.925. Increased vertebral marrow FF is noted in the osteoporotic spine. FF has an inverse correlation with the T-score obtained from BMD. MRI with FF measurement can provide indirect evidence of osteoporosis, which can be done under one roof, especially in young patients where we need to avoid ionizing radiation.
骨质疏松症是一种常见的代谢性骨病，可导致腰痛（LBP）。它通过双能X线吸收法（DXA）进行诊断。磁共振成像（MRI）是腰痛的常规检查方法，对检测椎体脂肪分数（FF）也很敏感，且FF会随着年龄增长而增加。本研究旨在通过MRI关联椎体骨髓FF与骨密度（BMD）。
纳入出现腰痛且疑似骨质疏松症的患者。所有患者均接受腰骶部脊柱MRI和DXA检查。根据DXA获得的T值将患者分为骨质疏松组和非骨质疏松组。BMD的“T值”< -2.5被视为骨质疏松性脊柱。T值> -2.5被视为非骨质疏松性。对两组间从MRI的DIXON序列获得的FF进行关联分析。
共纳入31例患者，平均年龄为54.26±11.6岁。根据方法中定义的标准，16例患者为骨质疏松症患者。骨质疏松症患者的平均椎体骨髓FF（64.98±8.8%）显著高于非骨质疏松症患者（45.18±13.2%）（P = 0.001）。发生骨折椎体的平均FF（69.19±7.73%）显著高于未发生骨折患者（57.96±5.75%）（P = 0.03）。以椎体骨髓FF的截断值54.85进行诊断，骨质疏松症的敏感性和特异性分别为93%和80%，95%置信区间。曲线下面积为0.925。
在骨质疏松性脊柱中观察到椎体骨髓FF增加。FF与从BMD获得的T值呈负相关。测量FF的MRI可提供骨质疏松症的间接证据，且可在同一检查中完成，尤其适用于需要避免电离辐射的年轻患者。
