磁共振波谱成像评价绝经前双侧卵巢切除术对骨髓脂肪的影响

目的探讨磁共振波谱成像(MRS)评估绝经前双侧卵巢切除术对腰椎骨髓脂肪的影响。方法收集32例接受子宫切除术和双侧卵巢切除术的患者(年龄47.4±2.8岁),分别在术前、术后第6个月、12个月行腰3椎体MRS扫描,测定骨髓脂肪分数(fat fraction,FF)。同时,定量CT测量L 3椎体松质骨容积骨密度(vBMD)。结果卵巢切除术后,腰椎vBMD呈现时序性降低而骨髓FF呈现急剧时序性增高。术后6个月骨髓FF及腰椎vBMD分别为(49.7±6.9)%、(134±22)mg/cc,FF急剧增加22.7%,而vBMD下降9.5%。术后12个月时骨髓FF及腰椎vBMD分别为(53.1±6.3)%、(128±24)mg/cc,分别较6个月时增高6.8%、降低4.5%。相关性分析示△vBMD6M-0M与△FF6M-0M(r=-0.801,P<0.001)、△vBMD12M-0M与△FF12M-0M(r=-0.769,P<0.001)以及△vBMD12M-6M与△FF12M-6M(r=-0.680,P<0.001)均存在负相关性。结论双侧卵巢切除术导致骨髓脂肪含量急剧增加,骨小梁密度减少。MRS测定卵巢切除术后骨髓脂肪或许可早于BMD探及骨髓分子生化成分变化。

MR spectroscopy-detected changes in marrow fat following bilateral oophorectomy in premenopausal women

Objective To investigate how soon marrow fat content changes occur following bilateral oophorectomy in premenopausal women assessed by MR spectroscopy(MRS).Methods 32 patients who underwent hysterectomy and bilateral oophorectomy were studied(mean age,47.4±2.8 years).Marrow fat fraction(FF)and volume BMD at the L 3 vertebral body were measured immediately prior to surgery and at 6,and 12 months after surgery by MRS and quantitative CT,respectively.Results Increased marrow FF and reduced vBMD occurred synchronously post-oophorectomy.At 6 months post-surgery,marrow FF and vBMD were(49.7±6.9)%and(134±22)mg/cc.There was a sharp increase of 22.7%in FF,a sharp decrease of 9.5%in vBMD at 6 months relative to baseline condition.At 12 months post-surgery,marrow FF and vBMD were(53.1±6.3)%and(128±24)mg/cc,with an increase of 6.8%in FF and a decrease of 4.5%in vBMD relative to 6 months.There were significant relationships in△6M-0M,△12M-0M and△12M-6M between marrow FF and lumbar spine vBMD(all P<0.001).Conclusion Bilateral oophorectomy results in a rapid increase in marrow fat content and a decrease in lumbar vBMD.MRS appears to be a valuable tool for assessment of marrow compositions at the relatively early stage.