Role of T1 Weighted and Diffusion Weighted Magnetic Resonance imaging application in the diagnosis of osteoporosis in lumbar spine in postmenopausal women
Keywords:
diffusion weighted magnetic resonance imaging, T1, osteoporosisAbstract
Background: Postmenopausal Osteoporosis is one of the most common causes of primary osteoporosis. For two decades, diffusion-weighted imaging (DWI) has been applied to the evaluation of intracranial diseases, but technical advancement make it possible to apply DWI measurements to extra cranial sites, including vertebral column.
Objective: Using diffusion-weighted MR imaging technology to determine the DWI and ADC values of lumbar vertebral body in postmenopausal women in correlation with the DEXA t-scores.
Patients and Methods: A cross sectional analytical studywas conducted at Al-Yarmouk Teaching hospital in Baghdad city. A total of 80 postmenopausal women, was recruited from subjects who underwent DEXA of the spine and categorized into three groups according to their t-score: Normal BMD, Osteopenia, and Osteoporosis. Then MRI study done for all of them including: T1, T2, DWI, and ADC value measurement.
Results: The values of ADC at L3 vertebra were (0.46 ± 0.098) × 10-3 mm2/s, (0.42 ± 0.084) × 10-3 mm2/s, and (0.39 ± 0.052) × 10-3 mm2/s for the three groups: the normal, osteopenic, osteoporotic respectively. The values of the diffusion signal intensity values at L3 vertebra were 134.5 ± 5.7 mm2/s, 112.7 + 3.4 mm2/s, 101.3 + 4.4 mm2/s respectively. There was a significant difference among the three groups in both diffusion and ADC measurement.
Conclusion: Both diffusion and ADC values are significantly lower in subjects with postmenopausal osteoporosis. There is a significant positive relationship between T score that was determined by DEXA, and the ADC value.
References
Consensus development conference: Diagnosis, prophylaxis, and treatment of osteoporosis. The American Journal of Medicine. 1993;94(6):646–50.
Kanis JA, Kanis JA. Assessment of fracture risk and its application to screening for postmenopausal osteoporosis: Synopsis of a WHO report. Osteoporosis International. 1994;4(6):368–81.
WHO Scientific Group on the Assessment of Osteoporosis at Primary Care Level. Summary Meeting Report: Brussels, Belgium, 5–7 May 2004. Geneva, Switzerland: World Health Organization; 2007.
Stone KL, Seeley DG, Lui L-Y, Cauley JA, Ensrud K, Browner WS, et al. BMD at Multiple Sites and Risk of Fracture of Multiple Types: Long-Term Results From the Study of Osteoporotic Fractures. Journal of Bone and Mineral Research. 2003Jan;18(11):1947–54.
Siris ES, Miller PD, Barrett-Connor E, Faulkner KG, Wehren LE, Abbott TA, et al. Identification and Fracture Outcomes of Undiagnosed Low Bone Mineral Density in Postmenopausal Women. Jama. 2001Dec;286(22):2815.
Schousboe JT, Shepherd JA, Bilezikian JP, Baim S. Executive Summary of the 2013 International Society for Clinical Densitometry Position Development Conference on Bone Densitometry. Journal of Clinical Densitometry. 2013;16(4):455–66.
Pinheiro MM, Neto ETDR, Machado FS, Omura F, Yang JHK, Szejnfeld J, et al. Risk factors for osteoporotic fractures and low bone density in pre and postmenopausal women. Revista de SaúdePública. 2010;44(3):479–85.
Compston J. Assessment of fracture risk and its application to screening for postmenopausal osteoporosis (WHO Technical Report Series No 843). Annals of the Rheumatic Diseases. 1995Jan;54(7):548–.
Kanis JA, Delmas P, Burckhardt P, Cooper C, Torgerson D. Guidelines for diagnosis and management of osteoporosis. Osteoporosis International. 1997;7(4):390–406.
Guglielmi G, Grimston SK, Fischer KC, Pacifici R. Osteoporosis: diagnosis with lateral and posteroanterior dual x-ray absorptiometry compared with quantitative CT. Radiology. 1994;192(3):845–50.
Link TM, Majumdar S, Augat P, et al. Proximal femur: assessment for osteoporosis with T2* decay characteristics at MR imaging. Radiology. 1998;209:531–536.
Cvijetić S, Koršić M. Apparent bone mineral density estimated from DXA in healthy men and women. Osteoporosis International. 2003;15(4):295–300.
Yoshikawa K. Early pathological changes in the parkinsonian brain demonstrated by diffusion tensor MRI. Journal of Neurology, Neurosurgery & Psychiatry. 2004Jan;75(3):481–4.
Eastwood JD, Lev MH, Wintermark M, et al. Correlation of early dynamic CT perfusion imaging with whole-brain MR diffusion and perfusion imaging in acute hemispheric stroke. American Journal of Neuroradiology. 2003; 24:1869–1875.
Taskin G, Incesu L, Aslan K. The value of apparent diffusioncoefficient measurements in the differential diagnosis of vertebralbone marrow lesions. Turkish Journal of Medical Sciences.2013; 43: 379-387.
Koh D-M, Collins DJ. Diffusion-Weighted MRI in the Body: Applications and Challenges in Oncology. American Journal of Roentgenology. 2007;188(6):1622–35.
Stejskal EO, Tanner JE. Spin Diffusion Measurements: Spin Echoes in the Presence of a Time‐Dependent Field Gradient. The Journal of Chemical Physics. 1995;42(1):288–92.
Neil JJ. Measurement of water motion (apparent diffusion) in biological systems. Concepts in Magnetic Resonance. 1997;9(6):385–401.
Ward R, Caruthers S, Yablon C, Blake M, Dimasi M, Eustace S. Analysis of Diffusion Changes in Posttraumatic Bone Marrow Using Navigator-Corrected Diffusion Gradients. American Journal of Roentgenology. 2000;174(3):731–4.
Nonomura Y, Yasumoto M, Yoshimura R, Haraguchi K, Ito S, Akashi T, et al. Relationship between bone marrow cellularity and apparent diffusion coefficient. Journal of Magnetic Resonance Imaging. 2001;13(5):757–60.
Turna O, Aybar MD, Tuzcu G, Karagoz Y, Kesmezacar O, Turna IF. Evaluation of Vertebral Bone Marrow with Diffusion Weighted MRI and ADC Measurements. Istanbul Medical Journal. 2014;15(2):116–21.
Hatipoglu H, Selvi A, Ciliz D, Yuksel E. Quantitative and Diffusion MR Imaging as a New Method To Assess Osteoporosis. American Journal of Neuroradiology. 2007Jan;28(10):1934–7.
Griffith JF, Yeung DK, Antonio GE, Wong SY, Kwok TC, Woo J, et al. Vertebral marrow fat content and diffusion and perfusion indexes in women with varying bone density: MR evaluation. Radiology. 2006;241:831‑8.
Fanucci E, Manenti G, Masala S, Laviani F, Costanzo GD, Ludovici A, et al. Multiparametercharacterisation of vertebral osteoporosis with 3-T MR. La radiologiamedica. 2007;112(2):208–23.
Liu Y, Tang GY, Tang RB, Peng YF, Li W. Assessment of bone marrow changes in postmenopausal women with varying bone densities: Magnetic resonance spectroscopy and diffusion magnetic resonance imaging. China Medical Journal (English). 2010;123:1524‑7.
Tang GY, Lv ZW, Tang RB, Liu Y, Peng YF, Li W, et al. Evaluation of MR spectroscopy and diffusion‑weighted MRI in detecting bone marrow changes in postmenopausal women with osteoporosis. Clinical Radiology. 2010;65:377‑81.
Kumar A, Agarwal Y, Chopra RK, Batra A, Chandra R, Thukral BB. Can bone marrow apparent diffusion coefficient values identify bone strength: Experience with 107 postmenopausal women. Astrocyte. 2015;2:64-8.
Koyama H, Yoshihara H, Kotera M, Tamura T, Sugimura K. The quantitative diagnostic capability of routine MR imaging and diffusion-weighted imaging in osteoporosis patients. Clinical Imaging. 2013;37(5):925–9
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