Clinical study of lumbar MRI screening for osteoporosis

XU Kai; SONG Yuan-li; MENG Ning-bo; XU Yue; ZHANG Ning

doi:10.11659/jjssx.08E025064

您当前的位置：

首页 >

文章列表页 >

Clinical study of lumbar MRI screening for osteoporosis

Clinical Research | 更新时间：2026-07-31

- Clinical study of lumbar MRI screening for osteoporosis
- JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY Vol. 35, Issue 8, Pages: 722-726(2026)
- 作者机构：
  
  1.淄博一四八医院骨科二区，山东淄博 255300
  2.山东大学齐鲁医院骨科，山东济南 250063
- 作者简介：
- 基金信息：
- DOI：10.11659/jjssx.08E025064
  CLC： R681.5+3;R445.2
- Received：17 August 2025，
  
  Online First：31 July 2026，
  
  Published：25 August 2026
- 稿件说明：
移动端阅览
徐凯,宋元礼,孟宁波等.腰椎MRI成像筛查骨质疏松症的临床研究[J].局解手术学杂志,2026,35(08):722-726.

XU Kai,SONG Yuan-li,MENG Ning-bo,et al.Clinical study of lumbar MRI screening for osteoporosis[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2026,35(08):722-726.
徐凯,宋元礼,孟宁波等.腰椎MRI成像筛查骨质疏松症的临床研究[J].局解手术学杂志,2026,35(08):722-726. DOI： 10.11659/jjssx.08E025064.

XU Kai,SONG Yuan-li,MENG Ning-bo,et al.Clinical study of lumbar MRI screening for osteoporosis[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2026,35(08):722-726. DOI： 10.11659/jjssx.08E025064.

摘要

目的

探究MRI的机会性应用在识别需进一步行骨骼健康评估的腰椎手术患者中的临床价值。

方法

回顾性分析2020年1月至2025年1月在淄博一四八医院连续接受术前骨健康优化（BHO）评估的83例患者的临床资料，所有患者术前均行无对比剂T1加权MRI检查及双能X射线吸收测定法（DXA）检查。根据WHO骨密度T值标准及临床骨质疏松症定义，将患者分为正常骨组（21例）、骨量减少组（34例）和骨质疏松组（28例）。采用全节段椎体骨质量（VBQ）评分、单节段VBQ评分、VBQ（脂肪）评分和信噪比（SNR）对MRI图像进行评估，同时收集骨折风险评估工具（FRAX）风险因素及骨小梁评分（TBS）指标。

结果

不同骨密度组患者的最低T值、TBS和全节段VBQ、单节段VBQ、VBQ（脂肪）评分及SNR比较，差异均具有统计学意义（

0.05）；其中全节段与单节段VBQ评分随骨密度降低呈阶梯式升高，组间两两比较差异均有统计学意义（

0.05）。

Pearson

相关性分析显示，患者最低T值（

=-0.64，

0.001）、TBS（

=-0.51，

0.001）与全节段VBQ评分均呈显著负相关。受试者工作特征（

ROC

）曲线分析显示，全节段VBQ、单节段VBQ、VBQ（脂肪）评分和SNR诊断骨质疏松症的曲线下面积（

AUC

）分别为0.806（95%

：0.700~0.911）、0.779（95%

：0.670~0.888）、0.608（95%

：0.475~0.742）和 0.586（95%

：0.461~0.711）。以最大约登指数确定的最佳诊

断阈值为：全节段VBQ评分2.95分（敏感度91%，特异度60%），单节段VBQ评分3.06分（敏感度91%，特异度44%）。FRAX高风险患者占比25.3%（21/83），其VBQ评分显著高于低风险患者（

0.001）。各组患者感兴趣区域（ROI）平均信号强度及标准差比较，差异有统计学意义（

0.001）。

Pearson

相关性分析显示，ROI平均信号强度与最低T值呈负相关（

=-0.58，

0.001）。

结论

腰椎MRI成像可用于筛查骨质疏松症，VBQ评分≥3分可作为识别需额外行DXA检查和骨骼健康干预的实用阈值，单节段VBQ评分因简便快速更适合临床推广。

Abstract

Objective

To investigate the clinical value of opportunistic application of MRI in identifying lumbar surgery patients who need further bone health assessment.

Methods

A retrospective analysis was conducted on the clinical data of 83 patients who received preoperative bone health optimization （BHO） evaluation in the 148th Hospital from January 2020 to January 2025. All patients underwent non-contrast T1-weighted MRI and dual-energy X-ray absorptiometry （DXA） before surgery. According to the WHO bone density T-score standard and clinical definition of osteoporosis，patients were divided into the normal bone group （21 cases），osteopenia group （34 cases） and osteoporosis group （28 cases）. MRI images were evaluated by whole-segment vertebral bone quality （VBQ） score，single-segment VBQ score，VBQ （fat） score and signal-to-noise ratio （SNR）. Meanwhile，risk factors of fracture risk assessment tool （FRAX） and trabecular bone score （TBS） indicators were collected.

Results

There were significant differences in the lowest T value，TBS， whole-segment VBQ scores，single-segment VBQ score，VBQ （fat） score and SNR among different bone density groups （

0.05）. Among them， the VBQ scores of the whole segment and the single segment increased in a stepwise manner with the decrease of bone mineral density， and the pairwise comparisons between groups showed statistically significant differences （

0.05）.

Pearson

correlati

on analysis showed that the lowest T value （

=-0.64，

0.001） and TBS （

=-0.51，

0.001） of patients were significantly negatively correlated with the whole-segment VBQ score.

Receiver operating characteristic

（

ROC

） curve analysis showed that the

area under the curve

（

AUC

） of whole-segment VBQ score， single-segment VBQ score， VBQ （fat） score， and SNR for diagnosing osteoporosis were 0.806 （95%

： 0.700 to 0.911）， 0.779 （95%

： 0.670 to 0.888）， and 0.608 （95%

： 0.475 to 0.742） and 0.586 （95%

： 0.461 to 0.711）， respectively. The optimal diagnostic thresholds determined by the maximum Youden index were as follows： the whole-segment VBQ score is 2.95 points （sensitivity 91%， specificity 60%）， and the single-segment VBQ score is 3.06 points （sensitivity 91%， specificity 44%）. The proportion of high-risk FRAX patients was 25.3% （21/83）， and their VBQ score was significantly higher than that of low-risk patients （

0.001）. There were statistically significant differences in the average region of interest（ROI） signal intensity and standards deviation among the groups of patients （

0.001）.

Pearson

correlation analysis showed that the average ROI signal intensity was negatively correlated with the lowest T value （

=-0.58，

0.001）.

Conclusion

Lumbar MRI can be used to screen for osteoporosis. VBQ score of ≥3 points can serve as a practical threshold for identifying the need for additional DXA examination and bone health intervention.The single-segment VBQ score is more suitable for clinical promotion due to its simplicity and speed.

关键词

Keywords

references

Lin X ， Shen R ， Zheng X ， et al . Utilizing radiomics techniques to isolate a single vertebral body from chest CT for opportunistic osteoporosis screening ［J］. BMC Musculoskelet Disord ， 2024 ， 25 （ 1 ）： 785 . doi： 10.1186/s12891-024-07903-2 http://dx.doi.org/10.1186/s12891-024-07903-2 .

Park H ， Han S ， Hwang Y ， et al . Skeletal muscle measurements based on abdominal computerized tomography （CT） predict risk of osteoporosis in incident hemodialysis patients ［J］. J Clin Med ， 2024 ， 13 （ 24 ）： 7696 . doi： 10.3390/jcm13247696 http://dx.doi.org/10.3390/jcm13247696 .

胡运祥，朱艳敏，谢小清，等 . 中老年男性骨质疏松症的MRI影像组学模型构建与应用研究［J］. 影像技术， 2025 ， 37 （ 1 ）： 8 - 13 . doi： 10.3969/j.issn.1001-0270.2025.01.02 http://dx.doi.org/10.3969/j.issn.1001-0270.2025.01.02 .

蒋树兵，陈伯雄，胡根文 . 氢质子MR波谱及双回波同反相位成像评价腰椎骨质疏松的研究［J］. 影像科学与光化学， 2021 ， 39 （ 2 ）： 202 - 206 . doi： 10.7517/issn.1674-0475.200723 http://dx.doi.org/10.7517/issn.1674-0475.200723 .

Liu J ， Wang H ， Shan X ， et al . Hybrid transformer convolutional neural network-based radiomics models for osteoporosis screening in routine CT ［J］. BMC Med Imaging ， 2024 ， 24 （ 1 ）： 62 . doi： 10.1186/s12880-024-01240-5 http://dx.doi.org/10.1186/s12880-024-01240-5 .

Chen S ， Guo L ， Zhao H ， et al . Quantitative measurements of dual-energy CT parameters in the diagnosis of osteoporosis - a highly sensitive and specific technique： an observational study ［J］. Medicine （Baltimore）， 2024 ， 103 （ 27 ）： e38559 . doi： 10.1097/MD.000000000 0038559 http://dx.doi.org/10.1097/MD.0000000000038559 .

Park PSU ， Werner TJ ， Alavi A . PET/CT for the opportunistic screening of osteoporosis and fractures in cancer patients ［J］. Curr Osteoporos Rep ， 2024 ， 22 （ 6 ）： 553 - 560 . doi： 10.1007/s11914-024-00887-x http://dx.doi.org/10.1007/s11914-024-00887-x .

Pan J ， Lin P ， Gong S ， et al . Effectiveness of opportunistic osteoporosis screening on chest CT using the DCNN model ［J］. BMC Musculoskelet Disord ， 2024 ， 25 （ 1 ）： 176 . doi： 10.1186/s12891-024-07297-1 http://dx.doi.org/10.1186/s12891-024-07297-1 .

Park MS ， Ha HI ， Lim HK ， et al . Femoral osteoporosis prediction model using autosegmentation and machine learning analysis with PyRadiomics on abdomen-pelvic computed tomography （CT）［J］. Quant Imaging Med Surg ， 2024 ， 14 （ 6 ）： 3959 - 3969 . doi： 10.21037/qims-23-1751 http://dx.doi.org/10.21037/qims-23-1751 .

Kucukciloglu Y ， Sekeroglu B ， Adali T ， et al . Prediction of osteoporosis using MRI and CT scans with unimodal and multimodal deep-learning models ［J］. Diagn Interv Radiol ， 2024 ， 30 （ 1 ）： 9 - 20 . doi： 10.4274/dir.2023.232116 http://dx.doi.org/10.4274/dir.2023.232116 .

Fang K ， Zheng X ， Lin X ， et al . A comprehensive approach for osteoporosis detection through chest CT analysis and bone turnover markers： harnessing radiomics and deep learning techniques ［J］. Front Endocrinol （Lausanne）， 2024 ， 15 ： 1296047 . doi： 10.3389/fendo.2024.1296047 http://dx.doi.org/10.3389/fendo.2024.1296047 .

Reginster J ， Czerwinski E ， Wilk K ， et al . Efficacy and safety of candidate biosimilar CT-P41 versus reference denosumab： a double-blind，randomized，active-controlled，phase 3 trial in postmenopausal women with osteoporosis ［J］. Osteoporos Int ， 2024 ， 35 （ 11 ）： 1919 - 1930 . doi： 10.1007/s00198-024-07161-x http://dx.doi.org/10.1007/s00198-024-07161-x .

Wang J ， He Y ， Yan L ， et al . Predicting osteoporosis and osteopenia by fusing deep transfer learning features and classical radiomics features based on single-source dual-energy CT imaging ［J］. Acad Radiol ， 2024 ， 31 （ 10 ）： 4159 - 4170 . doi： 10.1016/j.acra.2024. 04.022 http://dx.doi.org/10.1016/j.acra.2024.04.022 .

Pan J ， Lin P ， Gong S ， et al . Feasibility study of opportunistic osteoporosis screening on chest CT using a multi-feature fusion DCNN model ［J］. Arch Osteoporos ， 2024 ， 19 （ 1 ）： 98 . doi： 10.1007/s11657-024-01455-7 http://dx.doi.org/10.1007/s11657-024-01455-7 .

Xue C ， Lu X ， Sun G ， et al . Efficacy of opportunistic screening with chest CT in identifying osteoporosis and osteopenia in patients with T2DM ［J］. Diabetes Metab Syndr Obes ， 2024 ， 17 ： 2155 - 2163 . doi： 10.2147/DMSO.S462065 http://dx.doi.org/10.2147/DMSO.S462065 .

Tong X ， Wang S ， Zhang J ， et al . Automatic osteoporosis screening system using radiomics and deep learning from low-dose chest CT images ［J］. Bioengineering （Basel）， 2024 ， 11 （ 1 ）： 50 . doi： 10.3390/bioengineering11010050 http://dx.doi.org/10.3390/bioengineering11010050 .

Hu J ， Jin Y ， Wu J ， et al . Skeletal muscle index based on CT at the 12th thoracic spine level can predict osteoporosis and fracture risk： a propensity score-matched cohort study ［J］. Front Med （Lausanne）， 2024 ， 11 ： 1387807 . doi： 10.3389/fmed.2024.1387807 http://dx.doi.org/10.3389/fmed.2024.1387807 .

Chaisen M ， Sritara C ， Chitrapazt N ， et al . Opportunistic screening for osteoporosis by CT as compared with DXA ［J］. Diagnostics （Basel）， 2024 ， 14 （ 24 ）： 2846 . doi： 10.3390/diagnostics14242846 http://dx.doi.org/10.3390/diagnostics14242846 .

习楠，廖丹，李鑫，等 . 定量CT在骨质疏松症临床诊断与治疗中的应用研究进展［J］. 中国医学科学院学报， 2024 ， 47 （ 1 ）： 118 - 125 . doi： 10.3881/j.issn.1000-503X.16035 http://dx.doi.org/10.3881/j.issn.1000-503X.16035 .

Views

下载量

CSCD

Alert me when the article has been cited

提交

Tools

Publicity Resources

Correlation study between cystic degeneration of the humeral head and rotator cuff injury

Research progress of the cGAS-STING pathway in bone and joint diseases

Application of MRI diaphragmatic navigation technology combined with 3D LAVA-FLEX sequence in abdominal enhanced imaging of infants and young children

Research progress on gender differences in MRI brain structure and function in autism spectrum disorder

Research progress of cement-augmented pedicle screw instrumentation technique

Related Author

WANG Sheng-jun

WANG Yu-jie

BIAN Jin-song

ZHANG Cheng

LI Ang

MENG Xu-han

WANG Ying-na

RUAN Mo

Related Institution

Department of Joint and Sports Medicine， Cangzhou People's Hospital

Chengde Medical College

Department of Hepatology and Gastroenterology，Kunming Third People's Hospital

Department of Orthopedics，the 920th Hospital of the Joint Logistics Support Force

Department of General Surgery， Xuzhou Children's Hospital

⁰