概括
椎体骨质量 (VBQ) 评分是脊柱手术中使用常规术前 MRI 进行骨矿物质密度的机会性测量。VBQ 评分与年龄呈正相关，并且在连续扫描中可重复。然而，包括 MRI 机器和协议在内的外部因素会影响 VBQ 评分，因此必须标准化。
目的
本研究的目的是确定 VBQ 评分是否随着年龄的增长而增加，以及 VBQ 是否在 3 个月内获得的系列 MRI 研究中保持一致。
方法
这项回顾性研究评估了 136 名年龄在 20-69 岁之间的患者，他们在 2011 年 1 月至 2021 年 12 月期间的 3 个月内接受了两次 T1 加权腰椎 MRI。VBQ(L1-4) 评分计算为 L1-L4 信号的商强度 (SI) 和 L3 脑脊液 (CSF) SI。VBQ(L1) 得分计算为 L1 SI 和 L1 CSF SI 的商。进行回归分析以确定VBQ(L1-4)分数与年龄的相关性。变异系数 (CV) 用于确定连续 MRI 扫描的 VBQ(L1-4) 评分之间的再现性。
结果
本研究纳入了 136 名患者（平均±标准差，年龄 44.9±12.5 岁；53.7% 为女性）。影响 VBQ 评分的外在因素包括患者年龄、MRI 松弛时间和特定的 MRI 机器。当控制MRI松弛/回波时间时，VBQ(L1-4)评分与年龄呈正相关，并且在连续MRI中具有良好的重复性，CV为0.169。从两个公式 VBQ(L1) 和 VBQ(L1-4) 得出的 VBQ 分数非常一致 (ICC > 0.9)。
结论
外部因素（包括 MRI 技术因素和年龄）可能会影响 VBQ(L1-4) 评分，在使用此工具估计骨矿物质密度 (BMD) 时必须予以考虑。VBQ(L1-4)评分与年龄呈正相关。连续 MRI 中 VBQ(L1-4) 评分的可重复性非常出色，尤其是在控制技术因素时，支持使用 VBQ 评分来估计 BMD。VBQ(L1) 分数是 VBQ(L1-4) 分数的可靠替代方案。
"点击查看英文标题和摘要"
MRI-based vertebral bone quality score: relationship with age and reproducibility
Summary
Vertebral bone quality (VBQ) score is an opportunistic measure of bone mineral density using routine preoperative MRI in spine surgery. VBQ score positively correlates with age and is reproducible across serial scans. However, extrinsic factors, including MRI machine and protocol, affect the VBQ score and must be standardized.
Purpose
The purposes of this study were to determine whether VBQ score increased with age and whether VBQ remained consistent across serial MRI studies obtained within 3 months.
Methods
This retrospective study evaluated 136 patients, age 20–69, who received two T1-weighted lumbar MRI within 3 months of each other between January 2011 and December 2021. VBQ(L1-4) score was calculated as the quotient of L1–L4 signal intensity (SI) and L3 cerebral spinal fluid (CSF) SI. VBQ(L1) score was calculated as the quotient of L1 SI and L1 CSF SI. Regression analysis was performed to determine correlation of VBQ(L1-4) score with age. Coefficient of variation (CV) was used to determine reproducibility between VBQ(L1-4) scores from serial MRI scans.
Results
One hundred thirty-six patients (mean ± SD age 44.9 ± 12.5 years; 53.7% female) were included in this study. Extrinsic factors affecting the VBQ score included patient age, MRI relaxation time, and specific MRI machine. When controlling for MRI relaxation/echo time, the VBQ(L1-4) score was positively correlated with age and had excellent reproducibility in serial MRI with CV of 0.169. There was excellent agreement (ICC > 0.9) of VBQ scores derived from the two formulas, VBQ(L1) and VBQ(L1-4).
Conclusion
Extrinsic factors, including MRI technical factors and age, can impact the VBQ(L1-4) score and must be considered when using this tool to estimate bone mineral density (BMD). VBQ(L1-4) score was positively correlated with age. Reproducibility of the VBQ(L1-4) score across serial MRI is excellent especially when controlling for technical factors, supporting use of the VBQ score in estimating BMD. The VBQ(L1) score was a reliable alternative to the VBQ(L1-4) score.
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