Evaluation of vertebral bone marrow fat content by chemical-shift MRI in osteoporosis
Tóm tắt
To quantitatively evaluate vertebral bone marrow fat content and investigate its association with osteoporosis with chemical-shift magnetic resonance imaging (CS-MRI). Fifty-six female patients (age range 50–65 years) with varying bone mineral densities as documented with dual x-ray absorptiometry (DXA) were prospectively included in the study. According to the DXA results, the patients were grouped as normal bone density, osteopenic, or osteoporotic. In order to calculate fat content, the lumbar region was visualized in the sagittal plane by CS-MRI sequence. “Region of interest” (ROI)s were placed within L3 vertebral bodies and air (our reference point) at different time points by different radiologists. Fat content was calculated through “signal intensity (SI) suppression rate” and “SI Index”. The quantitative values were compared statistically with those obtained from DXA examinations. Kruskal–Wallis, and Mann–Whitney U tests were used for comparisons between groups. The reliability of the measurements performed by two radiologists was evaluated with the “intraclass correlation coefficient”. This study was approved by an institutional review board and all participants provided informed consent to participate in the study. Eighteen subjects with normal bone density (mean T score, 0.39 ± 1.3 [standard deviation]), 20 subjects with osteopenia (mean T score, –1.79 ± 0.38), and 18 subjects with osteoporosis (mean T score, –3 ± 0.5) were determined according to DXA results. The median age was 55.9 (age range 50–64 years) in the normal group, 55.5 (age range 50–64 years) in the osteopenic group, and 55.1 (age range 50–65 years) in the osteoporotic group (p = 0.872). In the CS-MRI examination, the values of “SI suppression ratio” and “SI Index” (median [min:max]) were calculated by the first and second reader, independently. There was no statistically significant difference between the groups with regard to vertebral bone marrow fat content (p > 0.05). According to the “intraclass correlation coefficient”, the measurements were reliable (0.55 and 0.60). Vertebral bone marrow fat content calculated with CS-MRI is not a reliable parameter for predicting bone mineral density in female patients aged between 50 and 65 years.
Tài liệu tham khảo
Yeung DK, Griffith JF, Antonio GE, Lee FK, Woo J, Leung PC. Osteoporosis is associated with increased marrow fat content and decreased marrow fat unsaturation: a proton MR spectroscopy study. J Magn Reson Imaging. 2005;22:279–85.
Griffith JF, Yeung DK, Antonio GE, et al. Vertebral marrow fat content and diffusion and perfusion indexes in women with varying bone density: MR evaluation. Radiology. 2006;241:831–8.
Griffith JF, Yeung DK, Antonio GE, et al. Vertebral bone mineral density, marrow perfusion, and fat content in healthy men and men with osteoporosis: dynamic contrast-enhanced MR imaging and MR spectroscopy. Radiology. 2005;236:945–51.
Schellinger D, Lin CS, Hatipoglu HG, Fertikh D. Potential value of vertebral proton MR spectroscopy in determining bone weakness. AJNR. 2001;22:1620–7.
Schellinger D, Lin CS, Lim J, et al. Bone marrow fat and bone mineral density on proton MR spectroscopy and dual-energy x-ray absorptiometry: their ratio as a new indicator of bone weakening. AJR. 2004;183:1761–5.
Shih TT, Chang CJ, Hsu CY, Wei SY, Su KC, Chung HW. Correlation of bone marrow lipid water content with bone mineral density on the lumbar spine. Spine. 2004;29:2844–50.
Liney GP, Bernard CP, Manton DJ, Turnbull LW, Langton CM. Age, gender, and skeletal variation in bone marrow composition: a preliminary study at 3.0 Tesla. J Magn Reson Imaging. 2007;26:787–93.
Kazakia GJ, Majumdar S. New imaging technologies in the diagnosis of osteoporosis. Rev Endocr Metab Disord. 2006;7:67–74.
Hatipoglu HG, Selvi A, Ciliz D, Yuksel E. Quantitative and diffusion MR imaging as a new method to assess osteoporosis. AJNR. 2007;28:1934–7.
Yeung DK, Wong SY, Griffith JF, Lau EM. Bone marrow diffusion in osteoporosis: evaluation with quantitative MR diffusion imaging. J Magn Reson Imaging. 2004;19:222–8.
Brismar TB. MR relaxometry of lumbar spine, hip, and calcaneus in healthy premenopausal women: relationship with dual energy X-ray absorptiometry and quantitative ultrasound. Eur Radiol. 2000;10:1215–21.
Link TM, Majumdar S, Augat P, et al. Proximal femur: assessment for osteoporosis with T2* decay characteristics at MR imaging. Radiology. 1998;209:531–6.
LeBlanc AD, Schonfeld E, Schneider VS, Evans HJ, Taber KH. The spine: changes in T2 relaxation times from disuse. Radiology. 1988;169:105–7.
Costa DN, Pedrosa I, McKenzie C, Reeder SB, Rofsky NM. Body MRI using IDEAL. AJR Am J Roentgenol. 2008;190:1076–84.
Kim H, Taksali SE, Dufour S, et al. Comparative MR study of hepatic fat quantification using singlevoxel proton spectroscopy, two-point Dixon and three-point IDEAL. Magn Reson Med. 2008;59:521–7.
Savci G, Yazici Z, Sahin N, Akgöz S, Tuncel E. Value of chemical shift subtraction MRI in characterization of adrenal masses. AJR. 2006;186:130–5.
Fujiyoshi F, Nakajo M, Fukukura Y, Tsuchimochi S. Characterization of adrenal tumors by chemical shift fast low-angle shot MR imaging: comparison of four methods of quantitative evaluation. AJR. 2003;180:1649–57.
Mitchell DG, Crovello M, Matteucci T, Petersen RO, Miettinen MM. Benign adrenocortical masses diagnosis with chemical shift MR imaging. Radiology. 1992;185:345–51.
Bilbey JH, McLoughlin RF, Kurkjian PS, et al. MR imaging of adrenal masses: value of chemical-shift imaging for distinguishing adenomas from other tumors. AJR. 1995;164:637–42.
Majumdar S, Genant HK, Grampp S, et al. Correlation of trabecular bone structure with age, bone, mineral density, and osteoporotic status: in vivo studies in the distal radius using high resolution magnetic resonance imaging. J Bone Miner Res. 1997;12:111–8.
Strolka I, Toffanin R, Guglielmi G, Frollo I. Image registration in the T2* measurements of the calcaneus used to predict osteoporotic fractures. Meas Sci Rev. 2005;5:78–81.
Vieth V, Link T, Lotter A, et al. Does the trabecular bone structure depicted by high-resolution MRI of the calcaneus reflect the true bone structure. Invest Radiol. 2001;36:210–6.
Sebag GH, Moore SG. Effect of trabecular bone on the appearance of marrow in gradient-echo imaging of the appendicular skeleton. Radiology. 1990;174:855–9.
Kanis JA, Delmas P, Burchardt P, et al. Guidelines for diagnosis and management of osteoporosis. Osteoporosis Int. 1997;7:390–406.
Phan CM, Matsuura M, Bauer JS, et al. Trabecular bone structure of the calcaneus: comparison of MR imaging at 3.0 and 1.5 T with micro-CT as the standard of reference. Radiology. 2006;239:488–96.
Demmler K, Otte P, Bartl R, Burkhardt R, Frisch B, Jahn A. Osteopenia, marrow atrophy and capillary circulation. Comparative studies of the human iliac crest and 1st lumbar vertebra. Z Orthop Ihre Grenzgeb. 1983;121:223–7.
Rozman C, Feliu E, Berga L, Reverter JC, Climent C, Ferran MJ. Age-related variations of fat tissue fraction in normal human bone marrow depend both on size and number of adipocytes: a stereological study. Exp Hematol. 1989;17:34–7.
Justesen J, Stenderup K, Ebbesen EN, Mosekilde L, Steiniche T, Kassem M. Adipocyte tissue volume in bone marrow is increased with aging and in patients with osteoporosis. Biogerontology. 2001;2:165–71.
Dixon WT. Simple proton spectroscopic imaging. Radiology. 1984;153:189–94.
Ragab Y, Emad Y, Gheita T, et al. Differentiation of osteoporotic and neoplastic vertebral fractures by chemical shift in-phase and out-of phase MR imaging. Eur J Radiol. 2009;72:125–33.
Baker LL, Goodman SB, Perkash I, Lane B, Enzmann DR. Benign versus pathologic compression fractures of vertebral bodies: assessment with conventional spin-echo, chemical-shift, and STIR MR imaging. Radiology. 1990;174:495–502.
Zajick Jr DC, Morrison WB, Schweitzer ME, Parellada JA, Carrino JA. Benign and malignant processes: normal values and differentiation with chemical shift MR imaging in vertebral marrow. Radiology. 2005;237:590–6.
Dunnill MS, Anderson JA, Whitehead R. Quantitative histological studies on age changes in bone. J Pathol Bacteriol. 1967;94:275–91.
Burkhardt R, Kettner G, Bohm W, et al. Changes in trabecular bone, hematopoiesis and bone marrow vessels in aplastic anemia, primary osteoporosis and old age: a comparative histomorphometric study. Bone. 1987;8:157–64.
Kugel H, Jung C, Schulte O, Heindel W. Age- and sex-specific differences in the 1H-spectrum of vertebral bone marrow. J Magn Reson Imaging. 2001;13:263–8.
De Bisschop E, Luypaert R, Louis O, et al. Fat fraction of lumbar bone marrow using in vivo proton nuclear magnetic resonance spectroscopy. Bone. 1993;14:133–6.
Baur A, Stabler A, Bartl R, Lamerz R, Scheidler J, Reiser M. MRI gadolinium enhancement of bone marrow: age-related changes in normals and in diffuse neoplastic infiltration. Skeletal Radiol. 1997;26:414–8.
Dooms GC, Fisher MR, Hricak H, Richardson M, Crooks LE, Genant HK. Bone marrow imaging: magnetic resonance studies related to age and sex. Radiology. 1985;155:429–32.
Ishijima H, Ishizaka H, Horikoshi H, et al. Water fraction of lumbar vertebral bone marrow estimated from chemical shift misregistration on MR imaging: normal variations with age and sex. AJR. 1996;167:355–8.