单体素1-H MRS在脊柱良恶性压缩性骨折鉴别诊断中的应用

目的:探讨磁共振氢质子波谱（proton magnetic resonance spectroscopy,1H -MRS）在脊柱骨质疏松和恶性肿瘤所致的压缩骨折中的不同特征，为鉴别脊柱良恶性压缩性骨折提供科学的依据。方法:收集2017年2月至2018年3月在西安市红会医院就诊的研究对象共109例，其中骨量正常组21例，骨量减少组38例，骨质疏松压缩骨折组28例，肿瘤压缩性骨折组22例。收集患者的年龄、性别和BMI等指标，所有研究对象均进行脂肪分数和脂水比值等指标的测量。本次研究采用3.0 T Siemens超导MR机及体部线圈进行波谱的采集。结果:四个组之间的脂肪分数和脂水比值之间存在显著差异。对于MRS FF而言，肿瘤组的MRS FF最低，为（16.3±6.7）%，骨质疏松组最高为（68.3±5.75）%，通过Bonferroni法进行不同组别之间的两两比较，发现任意两组之间均存在统计学差异，P＜0.001。MRS 脂肪分数（fat fraction，FF）和脂水比(lipid water ratio，LWR)具有高度相关性（r=0.835,P＜0.001）。结论:单体素1-H MRS在骨质疏松和肿瘤导致的压缩骨质中的MRS FF和LWR之间具有显著的统计学差异，可以有效的进行脊柱良恶性压缩性骨折的鉴别诊断。

Application of single voxel 1-H MRS in differential diagnosis of benign and malignant compression fracture of spine

Objective:To investigate the characteristics of single voxel 1-H MRS in benign and malignant spinal compression fractures due to osteoporosis and malignant tumors of the spine and to provide scientific basis for differentiating benign or malignant compression fractures of the spine.Methods: A total of 109 subjects were collected from February 2017 to March 2018 in Xi'an Honghui Hospital,including 21 patients in the normal group,38 in the bone loss reduction group,28 in the osteoporosis compression fracture group,and 22 in the tumor compression fracture group.The patient's age,gender and BMI were collected and all subjects were measured for fat fraction and lipid water ratio.In this study,3.0 T Siemens superconducting MR machines and body coils were used to acquire the spectrum.Results: There was a significant difference among the fat fraction and the lipid water ratio among the four groups.For MRS FF,the MRS FF in tumor group was the lowest (16.3±6.7)%,and the highest in osteoporosis group was (68.3±5.75)%.The two groups were compared by Bonferroni method.There was a statistical difference,P＜0.001.There was a high correlation between MRS FF and LWR(r=0.835,P＜0.001).Conclusion:Single voxel 1-H MRS has significant statistical differences between MRS FF and LWR in osteoporosis and tumor-induced benign and malignant compressed bone and can be used for the differential diagnosis of benign and malignant compression fractures of the spine.