磁共振扩散加权成像于骨质疏松椎体骨折的评估

目的探讨椎体扩散加权成像（DWI）对骨质疏松相关椎体骨折的评估价值。方法77例女性，年龄30～80岁，平均年龄（53±11）岁。志愿者先行腰椎常规矢状面T2WI、T1wI和横轴面T2WI扫描；常规扫描结束后采用SS-SE-EPIDWI序列（b=300s／mm^2）进行L2～L4椎体横轴位DWI扫描，并测量相应椎体中部横断面的表观扩散系数（ADC值）。结果随年龄增大椎体ADC值呈逐步减低趋势。骨质疏松椎体骨折组平均ADC值（0．237×10^-3mm^2／s）低于正常椎体组（O．557x10^-3mm^2／S），P〈O．01；ADC值判断椎体骨折的受试者工作特征曲线（ROC）面积为0．802（95％C10．687～O．916）。结论椎体骨髓变化状况可以通过DWI进行无创性地评估，进而来评估骨髓的变化对于骨质疏松椎体骨折所带来的影响。

Pilot study of MR diffusion weighted imaging in evaluating osteoporosis vertebral fracture

Objective To investigate the value of DWI in evaluating vertebral fracture. Methods A sum of 77 female subjects （mean age （53 ± 11） years, range 30～80 years） were recruited in this study. All subjects underwent routine MRI examination （Sagittal T2 WI, T1 WI and Axial T2 WI）. After routine MRI, axial vertebral （L2～L4 ） DWI was performed with single shot spin-echo echo-planar imaging （SS-SE-EPI） sequence （b value= 300 s/mm^2 ）. Apparent diffusion coeffi- cient （ADC） was measured. Results There was a decreasing tendency in ADC value with aging. The ADC （0. 237× 10^-3 mm~2/s） of vertebral fracture group was lower than that（0. 557 × 103 mm^2/s）of control group （ P d0.01）. The corre- sponding ROC area of ADC in evaluating vertebral fracture was 0. 802 95 %CI （0. 687～0. 916）. Conclusion DWI could be a useful tool to noninvasively evaluate the vertebral bone marrow changes, which could partially predict the pathophysiolo- gy changes of bone marrow in suhiects with osteoporosis vertebral fracture.