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目的探讨绝经后女性腰椎骨髓脂肪分数(fatfraction,FF)、表观扩散系数(apparent diffusion coefficient,ADC)值与骨密度(bone mineral densities,BMD)的关系。资料与方法将行腰椎双能量X线吸收测定(dual X-ray absorptionmetry,DXA)的60例绝经后女性根据T值分为3组:骨质正常组(T>-1.0)20例,骨质减少组(T=-1.0～-2.5)20例,骨质疏松组(T<-2.5)20例。所有研究对象均行氢质子磁共振波谱分析(1H MR spectroscopy,1H-MRS)、MR扩散加权成像(diffusion weighted imaging,DWI),分别测定L3椎体FF和ADC值。采用组间t检验对不同骨质组间FF、ADC值差异进行统计学分析。采用Pearson相关分析3组间FF、ADC值与BMD的相关性。结果骨质疏松组脂肪含量[(59.1±8.8)%,P=0.003]与骨质减少组脂肪含量[(54±7.6)%,P=0.039]均比骨质正常组[(49±9.1)%]高。骨质疏松组比骨质减少组椎体脂肪含量高(P=0.045)。椎体骨髓ADC值与T值无相关性。所有绝经后女性患者FF值与T值呈负相关(r=-0.46,P<0.01),与ADC值间呈轻度负相关(r=-0.25,P<0.05),但骨质疏松组中FF值与ADC值间呈较明显负相关(r=-0.72,P<0.01)。ADC值与T值无相关性(r=0.315,P>0.05)。结论绝经女性椎体骨髓脂肪含量随着BMD的减小而增大。MRS可作为BMD检查的辅助手段。MRS与DWI可以无创性了解骨质疏松症患者骨髓的生理、病理变化,单纯DWI并不能反映BMD的改变。
Objective To investigate the relationship between fatfraction (FF), apparent diffusion coefficient (ADC) and bone mineral densities (BMD) in postmenopausal women. Materials and Methods Sixty postmenopausal women undergoing dual X-ray absorptiometry (DXA) were divided into three groups according to T value: 20 cases of normal bone group (T> -1.0), 20 cases of bone mass There were 20 cases in the group (T = -1.0 ~ -2.5) and 20 cases in the group of osteoporosis (T <-2.5). All subjects underwent 1H MR spectroscopy (1H MRS) and diffusion weighted imaging (DWI). The FF and ADC values of L3 vertebral body were measured. The t-test between groups was used to analyze the difference of FF and ADC between different bone groups. Pearson correlation analysis between the three groups FF, ADC value and BMD correlation. Results In the osteoporosis group, the fat content in the osteopenia group was significantly higher than that in the normal bone group [(59 ± 8.8)%, P = 0.003] and osteopenia group [(54 ± 7.6)%, P = 0.039] %]high. Osteoporosis group osteopenia group vertebral body fat content was higher (P = 0.045). Vertebral bone marrow ADC value and T value was not related. There was a negative correlation between FF value and T value in all postmenopausal women (r = -0.46, P <0.01), and a slight negative correlation with ADC value (r = -0.25, P <0.05) FF value and ADC value showed a significant negative correlation (r = -0.72, P <0.01). There was no correlation between ADC value and T value (r = 0.315, P> 0.05). Conclusions The bone marrow fat content of vertebral bodies in postmenopausal women increases with the decrease of BMD. MRS can be used as an aid to BMD examination. MRS and DWI can noninvasively understand the physiological and pathological changes of bone marrow in osteoporosis patients. DWI alone can not reflect the changes of BMD.