A New Scoring System Based On Lumbar MRI Image To Assess Bone Mineral Density

ObjectiveTo establish a scoring system based on lumbar magnetic resonance imaging（MRI）images to evaluate bone mineral density and evaluate its correlation with T score of dual energy x-ray absorptiometry（DEXA）.MethodsRetrospective analysis of the clinical data of 82 patients admitted to our hospital from January 2019 to August 2020 diagnosed with degenerative lumbar disease and underwent surgical treatment.According to the lower T score of the femoral neck and total hip detected by DEXA,patients were divided into normal bone mass group（n=40）and osteopenia/osteoporosis group（n=42）.The vertebral bone quality（VBQ）score was calculated as the average signal intensity of L1-L4 vertebral bodies in the T1-weighted MRI image divided by the signal intensity of cerebrospinal fluid at L3 level.Then evaluate the ability of VBQ score to distinguish between normal bone mass and osteopenia/osteoporosis and the accuracy of predicting the occurrence of osteopenia/osteoporosis by drawing the receiver operating characteristic curve.The regression analysis was further used to determine the correlation between VBQ score and T value.ResultsThere was no significant difference in age,gender,body mass index,history of long-term hormone use and history of drinking between the two groups（P>0.05）.VBQ score in the osteopenia/osteoporosis group was significantly higher than that in the normal bone mass group,and the difference was statistically significant（P<0.05）.The area under curve of the ROC curve of the VBQ score was 0.93,the cut-off value was 2.98,the sensitivity was 81.6%,and the specificity was 88.6%.The correlation coefficient r between VBQ score and the lowest T value was 0.77.ConclusionThe VBQ score can be used to assess bone mineral density with an accuracy of 93%.When VBQ is 2.98,the sensitivity of 81.6%and the specificity of 88.6%can distinguish between normal bone mass and osteopenia/osteoporosis（a value higher than this value is osteopenia/osteoporosis,and a value less than this value is normal bone mass）.VBQ score is moderately negatively correlated with the lowest T value.Thus,the VBQ score can effectively distinguish normal bone mass from osteopenia/osteoporosis.