Abstract:Objective: To prospectively analyze 1H MRS features of the vertebral bony changes in renal failure patients and evaluate its diagnostic value. Materials and Methods: In 64 patients with clinically diagnosed chronic renal failure had 1H MRS of the second lumbar vertebra(L2) as the chronic renal failure group(CRF) and at the same time, 34 age matched healthy volunteers were recruited as control group. The fat fraction percent(FF%) and lipid-to-water(LWR) in ROI of the L2 were quantitatively analyzed. The differences between the two groups were compared, and the correlation with estimated glomerular filtrate rate(eGFR) and ROC curves were analyzed. Results: The mean FF% and mean LWR of L2 in the CRF group were (52.56±10.74)% and 1.25±0.68 respectively. The mean FF% and mean LWR of L2 in the control group were (43.24±12.19)% and 0.85±0.44 respectively. The mean FF% and the mean LWR of the CRF group were higher than those of the control group, the differences between the two groups were statistically significant(t=-3.752, P=0.000 and t=-3.512, P=0.001 respectively). In the CRF group, FF% was negatively related to eGFR(r=-0.264, P=0.035); the LWR was also negatively related to eGFR(r=-0.264, P=0.035). The ROC of FF% was 0.706, confidence internal(CI) was 95%(0.591~0.821), diagnostic critical value was 33.29%, the sensitivity was 0.984, the specificity was 0.296. The ROC of LWR was 0.706, CI was 95%(0.591~0.821), diagnostic critical value was 50.00%, the sensitivity and specificity were 0.984 and 0.296 respectively. Conclusion: 1H-MRS can be used as a non-invasive method to analyze the FF% and LWR of the vertebral body. So it can be used to assess the bony changes indirectly in CRF patients.