Evaluation of Primary Lumbar Vertebral Osteoporosis by MRI Fat Quantification Technique

Abstract Objective To investigate the diagnostic value of magnetic resonance imaging (MRI) 3D multi-echo-Dixon (ME-Dixon) and High-Speed T2-Corrected Multiecho Acquisition at 1H MR Spectroscopy (HISTO) sequences for lumbar spine osteoporosis. Method A total of 138 participants (aged 41–70) were enrolled in this study, including 75 females and 63 males. Perform MRI and quantitative computed tomography (QCT) examinations and record the body mass index (BMI), proton density fat fraction (PDFF) of lumbar spine L1-L4, and bone mineral density (BMD) measured by QCT. Analyze the correlation between PDFF and BMD, as well as the relationship between BMI and PDFF, BMD. Use receiver operating characteristic (ROC) curve to test the diagnostic efficacy of PDFF for osteoporosis. Analyze the differences in BMD and PDFF between the upper lumbar spine (L1 − 2) and lower lumbar spine (L3 − 4) in three different age groups: 41–50 years old, 51–60 years old, and 61–70 years old. Result The mean ME-Dixon-PDFF, HISTO-PDFF, and BMD of the lumbar spine were highly negatively correlated (r=-0.681, r=-0.557, p < 0.01); The area under the curve (AUC) of ME-Dixon-PDFF is 0.833, with a diagnostic threshold of 55.1% for osteoporosis, sensitivity of 88.0%, and specificity of 70.8%. The AUC of HISTO-PDFF is 0.819, with a diagnostic threshold of 61.4%, sensitivity of 84.0%, and specificity of 77.9% for osteoporosis. The correlation p values between BMI and lumbar spine ME-Dixon-PDFF mean, HISTO-PDFF mean, and BMD mean are 0.858, 0.399, and 0.363, respectively. The two PDFF values of L1-L4 showed an increasing trend, with the upper lumbar spine having lower PDFF values than the lower lumbar spine in the same age group, and no difference in BMD. Conclusion ME-Dixon-PDFF, HISTO-PDFF are significantly negatively correlated with BMD, and MRI fat quantification sequence is an effective complementary tool for diagnosing osteoporosis. Compared to the upper lumbar spine, the lower lumbar spine can better reflect bone mass.