Diagnostic Value Of Intravoxel Incoherent Motion Diffusion Weighted Imaging For Osteoporosis

Objective:To investigate the diagnostic value of diffusion weighted imaging?DWI?andIntravoxelincoherentmotion?IVIM?diffusionweightedimagingfor osteoporosis.And to compare the normal DWI apparent diffusion coefficient?ADC?,IVIM-DWI pure diffusion coefficient?D?,perfusion fraction?f?,perfusion-diffusion coefficient?D^*?of osteoporosis,osteopenia and normal bone mass vertebral bodies,Whether they have significant differences.Whether the above parameters are significantly different in the male and female groups.Whether these parameters are significantly different in the 20-39Y,40-59Y and 60-79Y groups.The correlation between ADC value,D value,D^*value,f value and bone mineral density value was studied.Methods:A total of 67 patients underwent DXA examination at the Physical Examination Center of Yanjishan Hospital from December 2016 to December 2018.All patients underwent lumbar spine MR examination within 7 days after completion of the DXA examination.The scan sequence included sagittal T1WI,sagittal T2WI,sagittal conventional DWI?b value was 0 and 1000 s/mm²?and IVIM-DWI?b values was 0,50,100,150,200,250,300,400,500,800,1000s/mm²?.The SIEMENS syngo MR post-processing workstation and third-party software MITK-diffusion was used to process the conventional DWI and IVIM-DWI images,and the region of interest?ROI?was delineated to obtain the ADC value,f value,D value and D^*value of the patient's vertebral body and generate the corresponding signal attenuation maps and parameter maps.All patients were divided into osteoporosis group,osteopenia group and normal bone mass group according to DXA examination results;patients were divided into male and female groups according to sex,patients were divided into 20-39 year group,40-59 year group and 60-79 year group according to age.One-way analysis of variance and Kruskal-Wallis H test were used to compare the differences of f value,D value,D^*value,ADC value and bone mineral density between the normal bone mass group,the low bone mass group and the osteoporosis group.The least significant difference?LSD?t test and the Mann-Whitney U test were used to compare the each two groups.The area under curve?AUC?was calculated by plotting the receiver operating characteristic curve?ROC?,and the sensitivity and specificity of each parameter for the diagnosis of osteoporosis were obtained.The diagnosis efficacy of each parameter was compared.Differences in f value,D value,D^*value,ADC value,and bone mineral density between the osteoporosis and non-osteoporosis groups,male and female groups were compared using two independent sample t-tests and Mann-Whitney U test.One-way analysis of variance and Kruskal-Wallis H test were used to compare f value,D value,D*value,ADC value and bone mineral density between 20-39 years old,40-59 years old and 60-79 years old.The least significant difference?LSD?t test and the Mann-Whitney U test were used to compare the each two groups.Pearson correlation was used to analyze the correlation between bone mineral density and IVIM related parameters and ADC values.RESULTS:A total of 67 patients?268 vertebral bodies?were included in the study,30patients?120 vertebral bodies?were osteoporosis,14 patients?56 vertebral bodies?were osteopenia,and 23 patients with normal bone mass?92 cases?.Grouped according to gender,including 16 male patients?64 vertebral bodies?and 51 female patients?204 vertebral bodies?.Grouped according to age,15 patients?60 vertebral bodies?aged 20-39years,30 patients?120 vertebral bodies?aged 40-59 years,and 22patients?88 vertebral bodies?aged 60-79 years old.There were statistically significant differences in f value,D value,ADC value and bone mineral density value between the osteoporosis group,the osteopenia group,and the normal bone mass group?p<0.05?.Further comparison between the two groups,osteoporosis and osteopenia group,the f value between the two groups was not statistically different?p>0.05?.The D^*values between osteoporosis and osteopenia group,osteoporosis and normal bone mass group was not statistically different?p>0.05?,osteopenia and normal bone mass group was statistically different?p<0.05?.The area under the curve of D value and ADC value for osteoporosis were 0.825 and 0.816,respectively.D is worthy of the highest diagnostic efficiency.The best diagnostic boundary value for identifying osteoporosis were0.37×10^-3mm²/s,0.38×10^-3mm²/s.There were statistically significant difference in D values,BMD values between male and female groups,males D values were smaller than females,but males BMD values were higher than females.The differences in f value,D value,ADC value and BMD value between the 20-39 years group,the 40-59years group,and the 60-79 years group were statistically significant?p<0.05?.D^*value was not not statistically different?p>0.05?.Further comparison between the two groups,the f-value between 40-59 years and 60-79 years group was not statistically different?p>0.05?.The correlation between D value and bone mineral density was0.314?p<0.001?,and the correlation between ADC value and bone mineral density value was0.38?p<0.001?.Conclusion:1.IVIM-DWI parameters pure diffusion coefficient D value and conventional ADC values help to diagnose vertebral osteoporosis,D value has the highest diagnostic efficiency.2.The optimal diagnostic threshold for osteoporosis is 0.37×10^-3mm²/s?AUC=0.825?,its sensitivity is 66%,specificity is 92%,and its diagnostic performance is better than that of traditional DWI.?AUC=0.816,diagnostic cut-off value 0.38×10^-33 mm²/s,sensitivity 74%,specificity 83%?has high diagnostic efficiency.3.The correlation between D value and bone mineral density value was 0.314,and the correlation between ADC value and bone mineral density value was 0.38.4.The D value of male vertebral body is smaller than that of female,and the male bone mineral density value is bigger than female.5.With the increase of age,the vertebral bone density value,ADC value and IVIM related parameter D value gradually decrease.