Osteoporosis MRI
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American Roentgen Ray Society Images of Osteoporosis MRI |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Eiman Ghaffarpasand, M.D. [2]
Overview
Magnetic resonance imaging (MRI) technique is very precise in measuring trabecular bone structure. MRI is a suitable replacement for multiple sites bone biopsy. Although 20% of the skeleton consists of trabecular bones, they have the highest impression from metabolic stimuli. In contrast with DEXA which measures both trabecular and cortical at the same time, MRI would be a better choice. The most impressive aspect of MRI in diagnosing osteoporosis is the ability to take in vivo images of trabecular bones. The plain resolution starts at about 150 μm and slice thickness starts at 300 μm; measuring trabecular bones precisely.
MRI
- Regarding that magnetic resonance imaging (MRI) technique is very precise in measuring trabecular bone structure, it could be a suitable surrogate for multiple sites bone biopsy. On the other hand, although 20% of skeleton consists of trabecular bones, they have the highest impression from metabolic stimuli; thus, in contrast with DXA which is measure both trabecular and cortical at the same time, MRI would be a better choice.[1]
- Trabecular bones are totally different from bone marrow in composition, making magnetic susceptibility gradient as bone-bone marrow interface. Whenever the interface become shallow and non-dramatic, the bone mass loss has begun. There are new techniques to identify the interface very precisely.[2]
- The most impressing aspect of MRI in diagnosing osteoporosis is the ability to take in vivo images of trabecular bones. The plain resolution starts at about 150 μm and slice thickness starts at 300 μm; measuring trabecular bones precisely.[1]
- Comparing dual energy X-ray absorptiometry (DXA), MRI has a good quantitative measurement of trabecular bones and also bone strength, therefore its usage is growing; but it is not expected to change the priority of osteoporosis survey by DXA. Considerable effect of MRI use on osteoporosis may include:
- The measure of trabecular bones through MRI method correlate with age, menopausal, osteoporotic, or fracture status; when compared to bone mineral density (BMD) measured by DXA, it shows moderate correlation. Whereas, by interpreting both MRI and DXA at the same time, the results become very precise and distinguishing between fractured and non-fractured bone would be improved.[3][4][5][6][7]
- Studies showed that following antiresorptive therapies, MRI survey of trabecular bones microstructure is better modality than DXA in estimating the treatment efficacy.[8]
- Also, in hypogonadism men, it seems that MRI modality with focusing on trabecular bone structures can show the bone mass loss more reliable than DXA method.[9]
- Typically, due to limitations of signal-to-noise ratio (SNR), MRI was done to evaluate peripheral bones, such as distal portions of extremities (e.g., tibia, femur, radius, or calcaneus). Meanwhile, the main sites of osteoporosis are central parts of the body (e.g., lumbar spine and femoral neck); therefore, recently SNR efficiency is improved and high-resolution MRI is widely used for femoral neck.[10]
By Dr Robert CARLIER, CHU Raymond Poincaré, Garches, France. [CC BY 2.0 (http://creativecommons.org/licenses/by/2.0)],
References
- ↑ 1.0 1.1 1.2 Majumdar S (2008). "Magnetic resonance imaging for osteoporosis". Skeletal Radiol. 37 (2): 95–7. doi:10.1007/s00256-007-0412-5. PMID 18034342.
- ↑ Majumdar S, Genant HK (1992). "In vivo relationship between marrow T2* and trabecular bone density determined with a chemical shift-selective asymmetric spin-echo sequence". J Magn Reson Imaging. 2 (2): 209–19. PMID 1562773.
- ↑ Majumdar S, Genant HK, Grampp S, Newitt DC, Truong VH, Lin JC, Mathur A (1997). "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. 12 (1): 111–8. doi:10.1359/jbmr.1997.12.1.111. PMID 9240733.
- ↑ Link TM, Majumdar S, Augat P, Lin JC, Newitt D, Lu Y, Lane NE, Genant HK (1998). "In vivo high resolution MRI of the calcaneus: differences in trabecular structure in osteoporosis patients". J. Bone Miner. Res. 13 (7): 1175–82. doi:10.1359/jbmr.1998.13.7.1175. PMID 9661082.
- ↑ Majumdar S, Link TM, Augat P, Lin JC, Newitt D, Lane NE, Genant HK (1999). "Trabecular bone architecture in the distal radius using magnetic resonance imaging in subjects with fractures of the proximal femur. Magnetic Resonance Science Center and Osteoporosis and Arthritis Research Group". Osteoporos Int. 10 (3): 231–9. PMID 10525716.
- ↑ Laib A, Newitt DC, Lu Y, Majumdar S (2002). "New model-independent measures of trabecular bone structure applied to in vivo high-resolution MR images". Osteoporos Int. 13 (2): 130–6. doi:10.1007/s001980200004. PMID 11905523.
- ↑ Boutry N, Cortet B, Dubois P, Marchandise X, Cotten A (2003). "Trabecular bone structure of the calcaneus: preliminary in vivo MR imaging assessment in men with osteoporosis". Radiology. 227 (3): 708–17. doi:10.1148/radiol.2273020420. PMID 12676974.
- ↑ Chesnut CH, Majumdar S, Newitt DC, Shields A, Van Pelt J, Laschansky E, Azria M, Kriegman A, Olson M, Eriksen EF, Mindeholm L (2005). "Effects of salmon calcitonin on trabecular microarchitecture as determined by magnetic resonance imaging: results from the QUEST study". J. Bone Miner. Res. 20 (9): 1548–61. doi:10.1359/JBMR.050411. PMC 4445726. PMID 16059627.
- ↑ Benito M, Gomberg B, Wehrli FW, Weening RH, Zemel B, Wright AC, Song HK, Cucchiara A, Snyder PJ (2003). "Deterioration of trabecular architecture in hypogonadal men". J. Clin. Endocrinol. Metab. 88 (4): 1497–502. doi:10.1210/jc.2002-021429. PMID 12679429.
- ↑ Krug R, Banerjee S, Han ET, Newitt DC, Link TM, Majumdar S (2005). "Feasibility of in vivo structural analysis of high-resolution magnetic resonance images of the proximal femur". Osteoporos Int. 16 (11): 1307–14. doi:10.1007/s00198-005-1907-3. PMID 15999292.