Semin Musculoskelet Radiol 2019; 23(S 02): S1-S18
DOI: 10.1055/s-0039-1692579
Abstracts
Georg Thieme Verlag KG Stuttgart · New York

Proton Magnetic Resonance Spectroscopy as a Novel Quantitative Method for Osteoporosis Detection

P. E. P. Menshchikov
1   Moscow, Russia
,
I. Melnikov
1   Moscow, Russia
,
A. Ivantsova
1   Moscow, Russia
,
A. Manzhurtsev
1   Moscow, Russia
,
M. Ublinskiy
1   Moscow, Russia
,
M. Akhlebinina
1   Moscow, Russia
,
T. Kostikova
1   Moscow, Russia
,
U. Polyakova
1   Moscow, Russia
,
T. Akhadov
1   Moscow, Russia
,
N. A. Semenova
1   Moscow, Russia
› Author Affiliations
Further Information

Publication History

Publication Date:
04 June 2019 (online)

 

Purpose: Osteoporosis is a skeletal disease characterized by a decrease in bone mineral density (BMD). It leads to an increased risk of fractures, for instance compression vertebral fracture (CVF). Quantitative computed tomography (QCT) is a commonly accepted method for assessing the disease. Spectra were obtained by localized proton magnetic resonance spectroscopy (1H MRS) from the cancellous bone (CB) of the vertebra. There are two main peaks in the spectrum: water peak (δ = 4.66 ppm) and the peak from bulk methylene protons of fat (δ = 1.20 ppm). The fat fraction (FF) index was calculated using FF = Ifat/(Ifat + Iwater), where Ii is the signal intensities. The aim of the study was to explore the relationship between FF and BMD in children.

Methods and Materials: Seventeen patients (10.9 ± 2.4 years) with CVF were studied. QCT was used to determine the BMD (mg/cm3) in vertebrae L3 and L4 using Philips Brilliance 16. 1H MR spectra (STEAM sequence, TR/TE, 3,000/12.8 ms; voxel size: 20 × 15 × 10 mm) were acquired from CB of lumbar vertebrae L3 and L4 using a 3-T MRI scanner.

Results: Correlation analysis revealed a significant inverse correlation link (R = − 0.51; p = 0.001) between FF and BMD for all vertebrae of all patients. Patients were classified into two groups: 7 mild CVF patients (one to two damaged vertebrae) and 10 severe CVF patients (more than two damaged vertebrae). Intergroup analysis revealed significantly increased FF (p < .005) and a reduction of BMD (p <.005) in patients with severe CVF as compared with mild CVF.

Conclusion: In the present work, we have studied, for the first time, the correlation between FF and BMD. A similar significant correlation link between these parameters measured in the lumbar vertebra was also found in middle-aged people and elderly people. Results of in vivo studies and results of previous histologic studies showed age-related replacement of bone tissue with the yellow bone marrow in vertebrae, confirming that the decrease in BMD and the increase in fat content in the bone marrow occur in parallel for different age groups. Our findings demonstrate that severe CVFs are associated with higher FF values and lower BMD values, whereas in cases of mild CVFs we see lower FF values and higher BMD values. That agrees with studies where positive correlation between BMD and vertebrae biomechanical strength was also revealed. Investigations showed that changes in fat content in the vertebra bone marrow measured with 1H MRS can be used for assessing BMD. A significant advantage of such a technique is the absence of ionizing radiation so screening can be used even in children.