目的 评估磁共振化学位移成像联合体质指数(BMI)对于青年骨量减少的诊断价值。方法 将67名受试者按照双源X线吸收法(DXA)骨密度测量结果分为骨量偏少组(n=38)及骨量正常组(n=29)。对两组被试进行膝关节MRI扫描并测量髌骨脂肪含量分数(FF),同时计算受试者的BMI值。对两组的FF及BMI值进行比较,运用ROC曲线分别评价两指标及两指标联合对于骨量减少的诊断效能;并对比两种指标联合与单个指标的诊断准确性。结果 骨量偏少组的髌骨FF值大于骨量正常组[(80.5±1.4)vs(78.6±1.2),P＜0.01],而骨量正常组BMI值大于骨量偏少组[(23.1±2.0)vs(20.2±1.9),P＜0.01]。ROC曲线分析显示:FF值诊断骨量减少的敏感度、特异度和AUC分别为68.4%、75.9%和0.808(95%CI:0.693～0.894);BMI值诊断骨量减少的敏感度、特异度和AUC分别为73.4%、89.7%和0.858(95%CI:0.751～0.931);两种指标联合诊断骨量减少的敏感度、特异度和AUC分别为86.8%、86.2%、0.920(95%CI:0.858～0.982);两种指标联合对于骨量减少的诊断效能优于单个指标(P=0.0136,P=0.0187)。结论 磁共振化学位移成像联合BMI指数可以较为准确地诊断青年骨量减少,可以作为评估青年骨量的一种可靠办法。
Abstract
ObjectiveTo investigate the applicability of chemical shift imaging combined with BMI(Body Mass Index) in diagnosing osteopenia among young patients.Methods A total of 67 youths were divided into the osteopenia group (n=38) and healthy group (n=29) according to the results of DXA(dual-energy X-ray absorptiometry). The fat fraction (FF) of the patella and BMI were measured and compared between the two groups. The receiver operating characteristic curve was used to analyze the (ROC) diagnostic value of each of the two indexes or the combination of the two indexes.Results The FF of the osteopenia group was higher than that of the healthy group[(80.5±1.4) vs (78.6±1.2),P＜0.01], while BMI of the osteopenia group was lower[(20.2±1.9) vs (23.1±2.0), P＜0.01]. The sensitivity, specificity and the AUC of the FF for diagnosis of osteopenia were 68.4%, 75.9% and 0.808 (95%CI: 0.693,0.894)respectively, compared with 73.4%, 89.7% and 0.858 (95%CI: 0.751,0.931)for BMI and 86.8%, 86.2% and 0.920 (95%CI:0.858,0.982)for the combination of the two indexs. The combined index was better than FF or BMI alone in diagnosis of osteopenia (P=0.0136,P=0.0187). Conclusions MR chemical shift imaging combined with BMI can accurately diagnose osteopenia, so it can be used as a reliable method to evaluate bone mass of youths.
关键词
青年 /
骨量减少 /
骨髓组织 /
磁共振成像 /
脂肪
Key words
youth /
osteopenia /
bone marrow /
magnetic resonance imaging /
fat
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基金
天津市科委重点研发计划(17YFZCSY00870);国家自然科学基金青年科学基金项目(81401401);天津市自然科学基金青年项目(16JCQNJC10900)
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