椎体脂肪MRI检测联合纹理分析预测压缩骨折椎体成形术后邻椎骨折风险的研究

椎体成形术是骨质疏松椎体压缩骨折最常用的手术方式，但术后邻近椎体骨折发生率增高，目前临床上缺乏对邻近椎体骨折风险评估的有效方法。研究已证实椎体成形术后脊柱生物力学改变，可能引起骨髓脂肪含量及成份变化，而该变化可能与邻近椎体骨折发生有关。我们前期通过MRI脂肪定量技术及MRS对椎体成形术后邻近椎体骨髓脂肪含量及成份进行测定，发现术后邻近椎体脂肪含量增高且饱和脂肪酸及不饱和脂肪酸含量发生变化。然而，骨髓脂肪的变化能否作为预测压缩骨折椎体成形术后邻近椎体骨折发生风险仍待进一步研究证实。因此，本研究拟采用MRI脂肪定量技术及MRS测量椎体骨髓脂肪含量、饱和脂肪酸及不饱和脂肪酸含量，并联合脂肪图纹理分析，构建基于骨髓脂肪的椎体骨质量评估MR生物学指标，用于骨质疏松压缩骨折椎体成形术后邻近椎体骨折风险的评估，有望为术后邻近椎体骨折的预测及骨健康状态提供新的监测手段。

Vertebroplasty is the most commonly used surgical method for osteoporotic vertebral compression fracture, but the incidence of adjacent vertebral fracture increased after surgery. Currently, there is no effective method for the risk assessment of adjacent vertebral fracture in clinical practice. Studies have demonstrated that biomechanical changes in the spine after vertebroplasty may lead to changes in bone marrow fat content and composition, which may be associated with the occurrence of adjacent vertebral fractures. We have previously measured the bone marrow fat content and components of adjacent vertebrae after vertebroplasty by MRI fat quantitative technology and MRS, and found that the fat fraction of adjacent vertebrae increased and the content of saturated fatty acids and unsaturated fatty acids changed after vertebroplasty. However, further research is needed to confirm whether changes in bone marrow fat can be used as a predictor of the risk of adjacent vertebral fractures after vertebroplasty of compression fracture. Therefore, this study aim to construct MR biological index for evaluating vertebral bone quality to predict adjacent vertebral fracture based on bone marrow fat by quantify vertebral bone marrow fat, saturated and unsaturated fatty acid using MRI fat quantitative technique, MRS and fat map texture analysis after vertebroplasty. This is expected to provide a new monitoring method for the prediction of adjacent vertebral fractures and bone health status after vertebroplasty.