磁共振STIR序列参数优化对急性腰椎骨折骨髓水肿诊断准确率与保守治疗并发症的预测价值OA

Objective:To investigate the impact of optimization of sequence parameters of Short-Tau Inversion Recovery(STIR)of magnetic resonance(MR)on diagnostic efficacy for bone marrow edema of acute lumbar fractures,and assess the predictive value of that for complications of conservative treatment.Methods:A prospective cohort of 100 patients with acute lumbar fractures,who admitted to hospital between January 2022 and May 2024,was enrolled.Participants were randomly divided into conventional parameter group(inversion time,TI=180 ms)and optimized parameter group(TI=210 ms)according to random number table.All subjects underwent magnetic resonance imaging(MRI)to collect images.The consistence rate of diagnosis,edema volume,and follow-up outcomes were compared between the two groups.Logistic regression was employed to analyze risk factors of occurring complication.Results:The consistence rate of diagnosis was 94.00%in the optimized parameter group,and that was 86.00%in the conventional parameter group,and the difference was not statistically significant(P>0.05).The diagnostic sensitivity and specificity of the optimized parameter group were respectively 93.33%and 95.65%,all of which were significantly higher than 84.44%and 88.89%of the conventional parameter group,and the differences of them were significant(x2=2.103,2.314,P<0.05).The total incidences of complications after treatment were decreased in the two groups,and the difference was significant(x2=8.012,P<0.05),and the degeneration of adjacent segment significantly decreased.Logistic regression analysis revealed that the risk of complications increased by 139%when edema volume increased 1 cm3[OR=2.39,95%Confidence Interval(CI):1.58-3.61)].The risk decreased 64%when T value of bone density decreased 1 standard deviation(OR=0.36,95%CI:0.19-0.71).The age of patient did not exhibit a statistically significant influence on complication(P>0.05).Conclusion:Optimized 210 ms of the TI values of STIR sequence can significantly enhance the diagnostic accuracy for bone marrow edema,and can reduce the risk of occurring complications in conservative treatment.Edema volume and composition of bone density are risk factors of occurring complications.