- 學位論文
以半自動影像分割方法評估核心肌群面積與骨質密度之相關性
Evaluation of the correlation between bone mineral density and core muscle area using semi-automatic image segmentation method.
摘要
背景與目的: 過去的研究會在核磁共振(MRI)影像上，使用手動圈選肌肉面積來評估肌肉質量的減少，然而此手動圈選的方式容易有主觀判斷的誤差。本研究目的是利用雙能量X光吸收儀(DXA)在成人所測得的骨質密度值(BMD)，與MRI在腰椎上所掃瞄出的核心肌群，再利用半自動的影像分割方法獲得核心肌群的肌肉面積，並且評估BMD與肌肉面肌的相關性。 材料與方法: 本研究回顧了85例接受過DXA與MRI檢查的停經後婦女，這兩種檢查時間不得超過3個月，患者分為50例的非骨質疏鬆患者，以及35例的骨質疏鬆患者。其年齡都要在50歲以上，且剔除有壓迫性骨折、骨刺、嚴重的脊椎側彎、開過刀、放過金屬植入物或是洗腎患者。本研究使用高斯混和模型進行半自動影像分割，在5張MRI橫切面上(L1-L2, L2-L3, L3-L4, L4-L5, L5-S1)分別測量豎脊肌的淨肌肉面積，接者使用皮爾森相關係數探討患者的BMD與淨肌肉面積及其他參數間的相關性。 結果: 相關分析結果顯示，BMD與肌肉面積、體重、BMI、年齡、停經年齡均呈顯著相關，而且在肌肉面積與BMD的分析中，L1-L2切面的淨肌肉面積與BMD有較高的顯著性。在非骨鬆族群中，僅L1-L2豎脊肌橫截面淨肌肉面積與L-spine的BMD呈現正相關性。然而，在骨鬆族群中，豎脊肌在不同切面上的淨肌肉面積幾乎都與L-spine的BMD值呈現正相關，其中L1-L2淨肌肉面積與BMD有最高的相關性。 討論與結論: 本研究顯示半自動的影像分割方法有助於準確地測量核心肌群的肌肉面積，透過核心肌群之橫截面淨肌肉面積之量測，可以評估停經婦女之骨質疏鬆的嚴重程度，此外，結果也顯示L1-L2比其他切面的淨肌肉面積與BMD有較高的顯著性，可能是因為上層切面與豎脊肌較其他切面垂直。因此，L1-L2豎脊肌橫截面淨肌肉面積是適合用來探討停經婦女的骨質疏鬆程度，除了與BMD有較高的相關性外，亦可降低所需影像分割時間。 關鍵詞:骨質密度、雙能量X光吸收儀、磁振造影、肌少症、停經婦女、骨質疏鬆、核心肌群
並列摘要
Background and Objective: Magnetic Resonance Imaging (MRI) has been previously utilized to evaluate the extent of muscle mass loss by manual drawing of muscle area which however is prone to subjective errors. The purpose of this study was to investigate the correlation between the bone mineral density (BMD) obtained from dual-energy X-ray absorptiometry (DXA) and the muscle area obtained from MRI using semi-automatic segmentation. Materials and Methods: This study reviewed 85 postmenopausal women who were older than 50 years old and had undergone both DXA and MRI examinations in 3 months. Of 85, 50 patients were without osteoporosis and 35 patients were with osteoporosis. None of them had compression fracture, osteophyte, severe scoliosis, bone surgery, metal implant, and dialysis. This study performed a semi-automatic Gaussian mixture segmentation method to obtain lean muscle area of erector spinae from five axial spine MRIs (L1-L2, L2-L3, L3-L4, L4-L5, L5-S1), and used Pearson’s correlational analysis to investigate the correlations between BMD, lean muscle area, and other parameters. Results: Correlational analysis showed that in 85 patients, the BMD was significantly correlated with muscle area, body weight, BMI, age, and duration of amenorrhea, and the L1-L2 muscle area was found to have higher correlation with BMD than those of lower slices. In non-osteoporotic group, the muscle area was significantly correlated with BMD only at L1-L2 slice. However, in osteoporotic group, the muscle areas of most slices were significantly correlated with BMD, and the muscle area at L1-L2 level had higher correlation than other levels. Discussion and Conclusion: This study demonstrated that the semi-automatic segmentation method is helpful to accurately measure the core muscle area which can be used to assess the severity of osteoporosis in postmenopausal women. The results also showed that the muscle area at L1-L2 level had higher significant correlation with BMD than other slices, suggesting that upper slice is more perpendicular to the erector spinae than lower slices and the obtained muscle cross-sectional area is more accurate. Therefore, we concluded that L1-L2 muscle area is suitable for investigating the severity of osteoporosis in postmenopausal women, not only because it has higher correlation with BMD but also because it takes less image analyzing time. Keywords: BMD, DXA, MRI, Sarcopenia, Postmenopausal Women, Osteoporosis, Core muscles
參考文獻
延伸閱讀
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