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影像新技术在骨质疏松疗效评估中的研究进展

     

摘要

骨质疏松(OP)是一种常见的全身代谢性骨病,以骨强度降低、易骨折为特征.药物治疗可延缓骨密度(BMD)降低,其疗效监测备受关注.双能X线骨密度测量(DXA)是诊断OP的金标准,但结果受多种因素影响,敏感性和特异性不高.定量CT(QCT)可测定代谢活跃的松质骨BMD,并且能排除周围组织影响,疗效监测较敏感.MR功能成像(MRS、DWI、DCE-MRI)及PET/CT能无创性定量监测骨髓脂肪含量、水分子运动及骨髓血流灌注水平,评估OP骨髓微环境的病理生理变化.就影像新技术对OP药物疗效评估的研究进展进行综述.%Osteoporosis (OP) is a systemic metabolic disease, which is characterized by loss of bone strength and increased susceptibility fractures. The number of OP patients in our country increases gradually and the time of onset shows a downward trend in age. In the recent years, drug treatment has been applied in clinical to delay the bone mineral density (BMD) decrease. Thus the monitoring efficacy of drugs is becoming important. Dual energy X-ray absorptiometry (DXA) is the golden standard for diagnosing OP, however, the sensitivity and specificity are low due to variety of factors affected. Quantitative computed tomography (QCT) can measure BMD of actively metabolized cancellous bone free of interruption from adjacent tissue, and is highly sensitive to the treatment effects. The functional MRI (MRS, DWI, and DCE-MRI) and PET/CT can be used to non-invasively evaluate the vertebral bone marrow and microstructure pathophysiology changes through the parameters of fat fraction (FF), molecular motion of water, and marrow perfusion. In the present paper we main-ly reviewed the advantages of new imaging technologies in diagnosis and evaluating efficacy of drugs for treatment of OP.

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