摘要
目的本研究旨在评估基于MRI椎体骨质量评分和CT骨微结构分析骨质疏松症患者腰椎手术骨质量,以期为临床诊治提供参考。方法在腰椎进行定量计算机断层扫描(QCT)测量,并使用L1/L2平均值将vBMD≤为120mg/cm3的患者分类为骨量减少/骨质疏松。采用矢状位T1加权磁共振扫描,将L1-L4椎体的平均信号强度除以脑脊液的信号强度,得出VBQ评分。术中取自髂后上棘的骨活检,并用MCT进行评估。比较正常组和骨量减少/骨质疏松组的VBQ评分和MCT参数。采用Spearman相关(R)分析VBQ评分、MCT参数与vBMD的相关性。ROC分析确定VBQ评分作为骨量减少/骨质疏松的预测因子。使用以vBMD L1/L2为结果的多元线性回归分析,从VBQ、MCT参数和人口统计学中识别独立预测因素。结果267例患者骨量减少/骨质疏松患病率为65.2%。VBQ评分与vBMD(r=-0.300;P<0.01)、骨小梁BV/TV(r=-0.314;P<0.01)、Tb.N(r=-0.326;P<0.01)呈显著负相关,并与Tb.Sp呈正相关(r=0.349;P<0.01)。VBQ评分预测骨量减少/骨质疏松症的预后准确性显示AUC值为0.670。多元线性回归分析显示,年龄(b=-0.400;P=0.003)、骨小梁体积分数(bv/tv)(b=0.420;P=0.012)和骨小梁厚度(Tb.Th)(b=-0.234;P=0.048)可预测体积骨密度。结论VBQ评分与MCT确定的骨小梁微结构有关,VBMD受损患者的骨显微结构和VBQ评分有显著差异。然而,用VBQ评分预测骨量减少/骨质疏松的能力是中等的。VBQ评分反映了额外的骨质量特征,并可能对vBMD具有补充作用。
Objective This study aims to evaluate the bone quality of lumbar fusion surgery in patients with osteoporosis based on MRI vertebral body bone quality score and CT bone microstructure analysis,in order to provide reference for clinical diagnosis and treatment.Methods Quantitative computed tomography(QCT)measurements were performed on the lumbar spine,and patients with vBMD≤120 mg/cm3 were classified as osteopenia/osteoporosis using L1/L2 mean values.Using sagittal T1 weighted magnetic resonance imaging,the average signal intensity of the L1 L4 vertebral body was divided by the signal intensity of the cerebrospinal fluid to obtain the VbQ score.bone biopsy taken from the posterior superior iliac spine during surgery and evaluated using MCT.Compare the VbQ scores and MCT parameters between the normal group and the bone loss/osteoporosis group.Spearman correlation(R)was used to analyze the correlation between VbQ score,MCT parameters,and vbMD.ROC analysis identified VbQ score as a predictive factor for bone loss/osteoporosis.Multiple linear regression analysis with vbMD L1/L2 as the result was used to identify independent predictors from VbQ,MCT parameters and Demographics.Results Osteopenia/osteoporosis prevalence in 267 patients It was 65.2 per cent.VbQ score and vbMD score(r=-0.300;P<0.01),bone trabecula bV/TV(r=-0.314;P<0.01),Tb.N(r=-0.326;P<0.01)had a significant negative correlation,and a positive correlation with Tb.Sp(r=0.349;P<0.01).The accuracy of VbQ score in predicting the prognosis of osteopenia/osteoporosis showed an AUC value of 0.670.Multiple linear regression analysis showed that age(b=-0.400;P=0.003),bone trabecular volume fraction(bv/tv)(b=0.420;P=0.012)and trabecular thickness(Tb.Th)(b=-0.234;P=0.048)predictable volumetric bone density.Conclusion The VbQ score is related to the bone trabecular microstructure determined by MCT,and there is a significant difference between the bone microstructure and VbQ score in patients with VbMD damage.However,the ability to predict bone loss/osteoporosis usin
作者
王树纯
张春海
李少轩
潘东续
高俊萍
周建昌
WANG Shu-chun;ZHANG Chun-hai;LI Shao-xuan;PAN Dong-xu;Gao Jun-ping;ZHOU Jian-chang(Department of Imaging,The Second Affiliated Hospital of Hebei North University,Zhangjiakou 075100,Hebei Province,China)
出处
《中国CT和MRI杂志》
2024年第12期164-166,共3页
Chinese Journal of CT and MRI
基金
河北省卫生健康委科研基金项目(20231469)
张家口市重点研发计划(2221159D)。
关键词
骨微结构
骨量减少
脊柱融合
体积骨密度
Bone Microstructure
Reduced Bone Mass
Spinal Fusion
Volume BoneDensity
