2023, Vol. 27 ›› Issue (4): 606-611

Lumbar MRI vertebral bone quality score to evaluate the severity of osteoporosis in postmenopausal women

Liu Hao, Yang Hongsheng, Zeng Zhimou, Wang Liping, Yang Kunhai, Hu Yongrong, Qu Bo   

Abstract: BACKGROUND: Although the current dual-energy X-ray bone densitometer is still the gold standard for the diagnosis of osteoporosis, the results of bone density measurement may be inaccurate due to vertebral disease and degenerative changes in the lumbar spine. Moreover, bone density can only reflect 60% of bone strength, which makes many scholars devote themselves to the study of diagnostic methods for osteoporosis. This study is dedicated to finding a detection method for screening or diagnosing osteoporosis through MRI.
OBJECTIVE: To explore the role of vertebral bone quality score based on lumbar MRI in the assessment of osteoporosis in postmenopausal women.
METHODS: The clinical data of 163 postmenopausal women diagnosed and treated in the First Affiliated Hospital of Chengdu Medical College from January 2017 to June 2021 were retrospectively analyzed. According to the dual-energy X-ray bone densitometer to obtain the hip T value, the subjects were divided into normal bone density group (n=48) and osteopenia/osteoporosis group (n=115). Vertebral bone quality score was measured. The general conditions, T value and vertebral bone quality score were compared between the two groups. The relationship between VBQ score and hip T value was analyzed. Receiver operating characteristic curve was used to evaluate the score in predicting the accuracy, specificity, sensitivity, and the threshold of osteoporosis.
RESULTS AND CONCLUSION: (1) There was no significant difference in body mass index, history of hypertension, history of diabetes, and history of long-term hormone use between the two groups (P > 0.05). The age of the osteopenia/osteoporosis group was significantly higher than that of the normal bone density group (P < 0.05). (2) Vertebral bone quality score in the osteopenia/osteoporosis group was significantly higher than that in the normal bone mass group (P < 0.05). (3) Vertebral bone quality score and femoral neck T-score showed the moderately negative correlation (r=-0.625, P < 0.01). (4) The accuracy of vertebral bone quality score in predicting osteopenia/osteoporosis was 81.9%; the cut-off value for diagnosing osteopenia/osteoporosis was 3.08, and the sensitivity was 86.1% and the specificity was 75.0%. (5) The vertebral bone quality score based on lumbar MRI has good values in the assessment of osteoporosis in postmenopausal women, and can be used as a supplementary method for the assessment of osteoporosis and an opportunistic sieve for measuring osteoporosis check method.
Key words: postmenopausal osteoporosis, vertebral bone quality score, bone quality, magnetic resonance imaging, bone mineral density