Emir Sevde Nur, Emir Servet
Department of Radiology, Umraniye Training and Research Hospital, University of Health Sciences, Istanbul 34764, Turkey.
Department of Internal Medicine, Umraniye Training and Research Hospital, University of Health Sciences, Istanbul 34764, Turkey.
Br J Radiol. 2025 Aug 1;98(1172):1327-1332. doi: 10.1093/bjr/tqaf132.
This study aims to evaluate the presence of osteoporosis by measuring the distal femur cortex thickness on routine knee MRI performed for any reason. We aim to determine if these measurements can serve as a reliable indicator of bone mineral density (BMD) and thus facilitate early diagnosis of osteoporosis.
A retrospective study was conducted with approval from the hospital's Ethics Committee. Patients who underwent dual-energy X-ray absorptiometry (DXA) and knee MRI within 6 months were included. Exclusion criteria were patients under 18, those with a gap of more than 6 months between scans, prior knee surgeries, trauma, bone tumours, or non-diagnostic MRI results. MRI examinations were performed on a 1.5 Tesla scanner. Measurements included average cortical bone thickness (CBTavg), distal femoral cortical index-1 (DFCI-1), and distal femoral cortical index-2 (DFCI-2). A radiologist blinded to DXA scores conducted the measurements. Statistical analyses were performed using the Mann-Whitney U test and receiver operating characteristic (ROC) analysis.
A total of 74 patients were included. Significant differences were found between the normal BMD group and the osteopenia/osteoporosis group for CBTavg, DFCI-1, and DFCI-2 (P < 0.01). ROC analysis showed high diagnostic accuracy with an area under the curve (AUC) of 0.92 for CBTavg, 0.90 for DFCI-1, and 0.91 for DFCI-2. Optimal cut-off values were determined as 4.52 mm for CBTavg, 2.58 mm for DFCI-1, and 1.12 mm for DFCI-2.
The study demonstrates that osteopenia/osteoporosis can be effectively diagnosed using distal femur cortex thickness measurements on routine knee MRI. These measurements provide a simple, fast, and practical method for opportunistically detecting osteoporosis, facilitating early intervention and management.
This study is the first to demonstrate that distal femur cortex thickness measurements on routine knee MRI can effectively predict osteoporosis, offering a novel, opportunistic screening method that enhances early detection and intervention strategies.
本研究旨在通过测量因任何原因进行的常规膝关节磁共振成像（MRI）上股骨远端皮质厚度来评估骨质疏松症的存在情况。我们旨在确定这些测量是否可作为骨密度（BMD）的可靠指标，从而有助于骨质疏松症的早期诊断。
在获得医院伦理委员会批准后进行了一项回顾性研究。纳入在6个月内接受双能X线吸收测定法（DXA）和膝关节MRI检查的患者。排除标准为18岁以下患者、两次扫描间隔超过6个月的患者、既往有膝关节手术史、创伤史、骨肿瘤或MRI检查结果无法诊断的患者。MRI检查在1.5特斯拉扫描仪上进行。测量包括平均皮质骨厚度（CBTavg）、股骨远端皮质指数-1（DFCI-1）和股骨远端皮质指数-2（DFCI-2）。由一位对DXA评分不知情的放射科医生进行测量。使用曼-惠特尼U检验和受试者工作特征（ROC）分析进行统计分析。
共纳入74例患者。正常骨密度组与骨量减少/骨质疏松组在CBTavg、DFCI-1和DFCI-2方面存在显著差异（P < 0.01）。ROC分析显示诊断准确性较高，CBTavg的曲线下面积（AUC）为0.92，DFCI-1为0.90，DFCI-2为0.91。确定的最佳截断值为CBTavg为4.52毫米，DFCI-1为2.58毫米，DFCI-2为1.12毫米。
该研究表明，使用常规膝关节MRI上的股骨远端皮质厚度测量可以有效诊断骨量减少/骨质疏松症。这些测量为机会性检测骨质疏松症提供了一种简单、快速且实用的方法，有助于早期干预和管理。
本研究首次表明，常规膝关节MRI上的股骨远端皮质厚度测量可以有效预测骨质疏松症，提供了一种新的机会性筛查方法，增强了早期检测和干预策略。
