Quantitative evaluation of lumbar spine osteoporosis by apparent diffusion coefficient and signal intensity ratio of magnetic resonance diffusion-weighted magnetic resonance imaging

Abstract

To investigate the application value of apparent diffusion coefficient (ADC) and signal intensity ratio (SIR) of MR diffusion-weighted imaging (DWI) in quantitative evaluation of lumbar spine osteoporosis. A total of 175 patients with lumbar spine diseases who received dualenergy X-ray absorption (DXA) bone mineral density (BMD), routine MRI and DWI of the lumbar spine from May 2017 to October 2019 were selected. According to the T-value of DXA, the patients were divided into osteoporosis group (64 cases), osteopenia group (53 cases) and normal bone mass group (58 cases). The ADC and SIR values of L2-L4 were measured and compared among the three groups and the correlation between ADC, SIR and BMD was analyzed. The ROC curve was used to evaluate the differential diagnosis value of ADC and SIR for osteoporosis, osteopenia and normal bone mass. There were statistically significant differences in ADC and SIR values among three groups (F=41.386, 37.114, all P=0.000). The ADC value of the osteoporosis group was lower than that of the osteopenia group and the normal bone mass group, and the difference was statistically significant (t=3.540, 9.069, P=0.001, 0.000);the SIR value of the osteoporosis group was higher than that of the osteopenia group and the normal bone mass group, and the difference was statistically significant (t=5.083, 8.523, all P=0.000). Spearman correlation analysis showed that ADC value was positively correlated with BMD (r=0.313, P=0.004);SIR value was negatively correlated with BMD (r=- 0.589, P=0.000). Receiver operator characteristic (ROC) curve analysis showed that the area under curve (AUC), sensitivity andspecificity of ADC and SIR in the diagnosis of lumbar osteoporosis and osteopenia were 0.742, 89.1% , 52.8% and 0.729, 89.1%, 50.9% respectively (P=0.000);the AUC, sensitivity and specificity of ADC and SIR in the diagnosis of lumbar osteoporosis and normal bone mass were 0.815, 100.0%, 50.0% and 0.856, 65.6%, 93.1%, respectively (P=0.000);the AUC, sensitivity and specificity of ADC and SIR in the diagnosis of lumbar osteoporosis were 0.78, 89.1%, 51.4% and 0.795, 50.0% and 94.6% respectively (P=0.000);All have a certain diagnostic value. ADC and SIR can better reflect the BMD of patients with lumbar diseases, and can quantitatively evaluate the vertebral body of osteoporosis, which play an important role in the diagnosis of lumbar osteoporosis.