现代仪器与医疗

双能X线骨密度仪联合MRI评估OVCF患者骨折严重程度及预后的应用研究

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殷玉锋 ^a , 黄振刚 ^b , 张丽霞 ^a

现代仪器与医疗 | 临床研究 2026,32(3): 83-88

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现代仪器与医疗 |临床研究 2026 , 32 (3) : 83 -88

双能X线骨密度仪联合MRI评估OVCF患者骨折严重程度及预后的应用研究

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殷玉锋^a, 黄振刚^b, 张丽霞^a

作者信息

^a.酒泉市中医医院　放射科，酒泉　735000

^b.酒泉市中医医院　骨伤二科，酒泉　735000

作者简介:

殷玉锋，男，本科，主治医师，研究方向：放射医学

Application of dual-energy X-ray absorptiometry combined with MRI in evaluating fracture severity and prognosis in patients with osteoporotic vertebral compression fractures

Yufeng Yin^a, Zhengang Huang^b, Lixia Zhang^a

Affiliations

^a.Department of Radiology, Jiuquan TCM Hospital, Jiuquan 735000, China

^b.Department of Orthopedics and Traumatology Ⅱ, Jiuquan TCM Hospital, Jiuquan 735000, China

出版时间: 2026-06-10 doi: 10.11876/mimt202603011

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摘要

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目的

探讨双能X线骨密度仪联合磁共振成像（magnetic resonance imaging，MRI）在评估骨质疏松性椎体压缩骨折（osteoporotic vertebral compression fracture，OVCF）严重程度及预测患者功能预后中的应用价值。

方法

纳入2023年12月至2025年7月于我院骨科住院治疗的OVCF患者70例。所有患者均接受双能X线骨密度仪及MRI检查，记录骨矿物质密度（bone mineral density，BMD）值、T值、椎体压缩率及骨髓水肿体积、信号强度比等影像学指标。依据Genant半定量法将患者分为轻度组、中度组和重度组。比较不同骨折严重程度患者的影像学指标及视觉模拟量表（visual analogue scale，VAS）评分、Oswestry功能障碍指数（Oswestry disability index，ODI）差异。采用Pearson分析评估影像学指标与VAS评分及ODI之间的相关性。根据治疗后6个月ODI改善率将患者分为预后良好组和预后不良组，采用多因素Logistic回归分析影响OVCF预后的独立危险因素，并通过受试者工作特征（receiver operating characteristic，ROC）曲线评估各指标及联合模型对预后不良的预测价值。

结果

三组患者随着骨折严重程度增加，BMD值及T值逐渐降低，椎体压缩率、骨髓水肿体积、信号强度比以及入院VAS评分和ODI逐渐升高，差异均有统计学意义（P<0.05）。Pearson相关性分析显示，BMD值与入院VAS评分、ODI均呈负相关（P<0.05）；骨髓水肿体积与入院VAS评分、ODI均呈正相关（P<0.05）。多因素Logistic回归分析显示，T值（OR=2.416，95%CI：1.213~4.798）、椎体压缩率（OR=3.121，95%CI：1.472~6.618）及骨髓水肿体积（OR=2.183，95%CI：1.134~4.209）均为OVCF患者预后不良的独立危险因素（P<0.05）。ROC曲线分析显示，T值、椎体压缩率及骨髓水肿体积预测OVCF预后不良的曲线下面积（area under curve，AUC）分别为0.763、0.781、0.752，而联合模型的AUC为0.892。

结论

T值、椎体压缩率及骨髓水肿体积与OVCF患者骨折严重程度及功能预后密切相关。双能X线骨密度仪联合MRI能够从骨量、椎体结构及骨髓反应等多维度综合评估OVCF，有助于预测患者预后情况，对指导临床个体化治疗具有重要价值。

关键词

骨质疏松性椎体压缩骨折 / 双能X线骨密度仪 / 磁共振成像 / 骨髓水肿 / 预后

Abstract

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Objective

To investigate the application value of dual-energy X-ray absorptiometry (DXA) combined with magnetic resonance imaging (MRI) in evaluating the fracture severity and predicting the functional prognosis in patients with osteoporotic vertebral compression fracture (OVCF).

Methods

70 patients with OVCF admitted to our hospital from December 2023 to July 2025 were included. All patients underwent DXA and MRI examinations, recording imaging parameters such as bone mineral density (BMD) values, T values, vertebral compression rate, bone marrow edema volume, and signal intensity ratio. According to the Genant semi quantitative method, the patients were divided into mild group, moderate group, and severe group. Compare the differences in imaging parameters, visual analogue scale (VAS) scores, and Oswestry disability index (ODI) among patients with different fracture severity. Pearson analysis was used to evaluate the correlation between imaging parameters, VAS scores, and ODI. According to the ODI improvement rate at 6 months after treatment, the patients were divided into good prognosis group and poor prognosis group. Multivariate logistic regression analysis was used to identify independent risk factors for poor prognosis. Receiver operating characteristic (ROC) curves were used to evaluate the predictive value of each indicator and combined model for poor prognosis.

Results

With the fracture severity increased, the BMD and T values gradually decreased, the vertebral compression rate, bone marrow edema volume, signal intensity ratio, VAS scores, and ODI gradually increased in the three groups, the differences were statistically significant (P<0.05). Pearson correlation analysis showed that BMD values were negatively correlated with VAS scores and ODI (P<0.05), the bone marrow edema volume was positively correlated with VAS scores and ODI (P<0.05). Multivariate logistic regression analysis indicated that T values (OR=2.416, 95%CI: 1.213~4.798), vertebral compression ratio (OR=3.121, 95%CI: 1.472~6.618), and bone marrow edema volume (OR=2.183, 95%CI: 1.134~4.209) were independent risk factors for poor prognosis (P<0.05). ROC curve analysis showed that the area under curve (AUC) of T values, vertebral compression ratio, and bone marrow edema volume for predicting the poor prognosis were 0.763, 0.781, and 0.752, while the AUC of the combined model was 0.892.

Conclusion

T values, vertebral compression rate, and bone marrow edema volume are closely related to the fracture severity and functional prognosis in patients with OVCF. DXA combined with MRI can comprehensively evaluate OVCF from multiple dimensions such as bone mass, vertebral structure, and bone marrow response, which is helpful in predicting the prognosis, and has important value in guiding individualized clinical treatment.

Key words

Osteoporotic vertebral compression fracture / Dual-energy X-ray absorptiometry / Magnetic resonance imaging / Bone marrow edema / Prognosis

引用本文

殷玉锋, 黄振刚, 张丽霞. 双能X线骨密度仪联合MRI评估OVCF患者骨折严重程度及预后的应用研究. 现代仪器与医疗, 2026 , 32 (3) : 83 -88 . DOI: 10.11876/mimt202603011

Yufeng Yin, Zhengang Huang, Lixia Zhang. Application of dual-energy X-ray absorptiometry combined with MRI in evaluating fracture severity and prognosis in patients with osteoporotic vertebral compression fractures[J]. Modern Instruments & Medical Treatment, 2026 , 32 (3) : 83 -88 . DOI: 10.11876/mimt202603011

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2026年第32卷第3期

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doi: 10.11876/mimt202603011

接收时间：2026-03-19
首发时间：2026-10-23
出版时间：2026-06-10

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作者信息

^a.酒泉市中医医院　放射科，酒泉　735000

^b.酒泉市中医医院　骨伤二科，酒泉　735000

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2种不同金属材料的力学参数

科 Family	属数 Number of genus	种数 Number of species	占总种数比例 Percentage of total species (%)	属 Genus	种数 Number of species	占总种数比例 Percentage of total species (%)
鹅膏菌科Amanitaceae	2	11	5.26	鹅膏菌属 Amanita	10	4.78
小菇科 Mycenaceae	2	12	5.74	丝盖伞属 Inocybe	5	2.39
多孔菌科 Polyporaceae	8	14	6.70	蜡蘑属 Laccaria	5	2.39
红菇科 Russulaceae	3	23	11.00	小皮伞属 Marasmius	6	2.87
				小菇属 Mycena	11	5.26
				光柄菇属 Pluteus	5	2.39
				红菇属 Russula	17	8.13
				栓菌属 Trametes	5	2.39

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