The Relationship Between Magnetic Resonance Diffusion Tensor Imaging Parameters and Muscle Dysfunction in Patients with Osteoporosis: A Cross-Sectional Retrospective Study

Objective: To explore the relationship between magnetic resonance (MR) diffusion tensor imaging (DTI) parameters and muscle dysfunction in patients with osteoporosis (OP), and provide a basis for clinical diagnosis and treatment. Methods: A retrospective study was conducted on 100 patients with osteoporosis treated in Ninth Medical Center of PLA General Hospital from January 2021 to January 2024. All patients underwent DTI examination and evaluated according to the Lovett muscle strength grading system (0– 5 levels). Patients with muscle strength grades 0– 3 were defined as the group with poor muscle function (n=31) and good muscle function (grades 4– 5, n=69). The affecting factors were analyzed through logistic regression model. Pearson model was used to analyze the correlation. Results: The fraction anisotropy (FA) values of the gluteus maximus, gracilis, rectus femoris, adductor femoris, and long adductor femoris in the poor group were all lower than the good group (all P< 0.05). The apparent diffusion coefficient (ADC) values of the gracilis muscle (1.02 ± 0.34 mm 2 /s vs 1.74 ± 0.41 mm 2 /s), adductor femoris muscle (1.07 ± 0.33 mm 2 /s vs 1.76 ± 0.38 mm 2 /s), and long adductor femoris muscle (1.04 ± 0.34 mm 2 /s vs 1.68 ± 0.34 mm 2 /s) were all lower than the good group (all P< 0.05). FA decrease and ADC increase in the adductor major and adductor longus muscles were independent factors affecting thigh muscle dysfunction (P< 0.05). The weakening of OP muscle function was positively correlated with the decrease of muscle FA and ADC (P< 0.05). The AUC predicted by the combination of FA and ADC was 0.722 (95% CI: 0.6239– 0.821), higher than those predicted by a single parameter (P< 0.05). Conclusion: There is a correlation between DTI parameters FA and ADC in different muscle parts and the occurrence of muscle dysfunction, and they have potential predictive value for muscle dysfunction in OP patients. Keywords: diffusion tensor imaging, magnetic resonance, osteoporosis, muscle microstructure, muscle function