Osteoporosis MRI: Difference between revisions

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__NOTOC__
{{Osteoporosis}}
{{Osteoporosis}}
{{CMG}}
{{CMG}}; {{AE}}{{EG}}
__NOTOC__
'''Associate Editor(s)-In-Chief:''' {{CZ}}, [[User:Raviteja Reddy Guddeti|Raviteja Guddeti, M.B.B.S.]][mailto:rgudetti@perfuse.org]


==Overview==
==Overview==
[[MRI]] provides a microstructural detail of the bone. It is very helpful in vertebral compression fractures. Short tau inversion recovery (STIR) sequence of MRI is very sensitive for detecting vertebral edema results from fresh fractures or micro-fractures.
[[Magnetic resonance imaging|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 bone|trabecular bones]], they have the highest impression from [[metabolic]] stimuli. In contrast with [[Dual energy X-ray absorptiometry|DEXA]] which measures both [[Trabecular bone|trabecular]] and [[Cortical bone|cortical]] at the same time, [[Magnetic resonance imaging|MRI]] would be a better choice. The most impressive aspect of [[Magnetic resonance imaging|MRI]] in diagnosing osteoporosis is the ability to take ''[[in vivo]]'' images of [[Trabecular bone|trabecular bones]]. The plain [[resolution]] starts at about 150 μm and slice thickness starts at 300 μm; measuring [[Trabecular bone|trabecular bones]] precisely.


==MRI==
==MRI==
Indications for [[MRI]] include:
* Regarding that [[Magnetic resonance imaging|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 bone|trabecular bones]], they have the highest impression from [[metabolic]] stimuli; thus, in contrast with [[Dual energy X-ray absorptiometry|DXA]] which is measure both [[Trabecular bone|trabecular]] and [[Cortical bone|cortical]] at the same time, [[Magnetic resonance imaging|MRI]] would be a better choice.<ref name="pmid18034342">{{cite journal |vauthors=Majumdar S |title=Magnetic resonance imaging for osteoporosis |journal=Skeletal Radiol. |volume=37 |issue=2 |pages=95–7 |year=2008 |pmid=18034342 |doi=10.1007/s00256-007-0412-5 |url=}}</ref>
* Vertebral compression fractures
* [[Trabecular bone|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 loss|bone mass loss]] has begun. There are new techniques to identify the interface very precisely.<ref name="pmid1562773">{{cite journal |vauthors=Majumdar S, Genant HK |title=In vivo relationship between marrow T2* and trabecular bone density determined with a chemical shift-selective asymmetric spin-echo sequence |journal=J Magn Reson Imaging |volume=2 |issue=2 |pages=209–19 |year=1992 |pmid=1562773 |doi= |url=}}</ref>
* Pre-surgical evaluation of Kyphoplasty
* The most impressing aspect of [[Magnetic resonance imaging|MRI]] in diagnosing [[osteoporosis]] is the ability to take ''[[in vivo]]'' images of [[Trabecular bone|trabecular bones]]. The plain [[resolution]] starts at about 150 μm and slice thickness starts at 300 μm; measuring [[Trabecular bone|trabecular bones]] precisely.<ref name="pmid18034342" />
* Adrenal tumors
* Comparing [[Dual energy X-ray absorptiometry|dual energy X-ray absorptiometry (DXA)]], [[Magnetic resonance imaging|MRI]] has a good quantitative measurement of [[Trabecular bone|trabecular bones]] and also [[bone]] strength, therefore its usage is growing; but it is not expected to change the priority of osteoporosis survey by [[Dual energy X-ray absorptiometry|DXA]]. Considerable effect of [[Magnetic resonance imaging|MRI]] use on [[osteoporosis]] may include:
** Complementary with ordinary [[Dual energy X-ray absorptiometry|DXA]]
** Treatment response survey in high-risk groups
** Schedule combination treatment protocols<ref name="pmid18034342" />


* The measure of [[Trabecular bone|trabecular bones]] through [[Magnetic resonance imaging|MRI]] method correlate with age, [[menopausal]], osteoporotic, or [[fracture]] status; when compared to [[Bone mineral density|bone mineral density (BMD)]] measured by [[Dual energy X-ray absorptiometry|DXA]], it shows moderate correlation. Whereas, by interpreting both [[Magnetic resonance imaging|MRI]] and [[DXA]] at the same time, the results become very precise and distinguishing between [[Fracture|fractured]] and non-[[Fracture|fractured]] [[bone]] would be improved.<ref name="pmid9240733">{{cite journal |vauthors=Majumdar S, Genant HK, Grampp S, Newitt DC, Truong VH, Lin JC, Mathur A |title=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 |journal=J. Bone Miner. Res. |volume=12 |issue=1 |pages=111–8 |year=1997 |pmid=9240733 |doi=10.1359/jbmr.1997.12.1.111 |url=}}</ref><ref name="pmid9661082">{{cite journal |vauthors=Link TM, Majumdar S, Augat P, Lin JC, Newitt D, Lu Y, Lane NE, Genant HK |title=In vivo high resolution MRI of the calcaneus: differences in trabecular structure in osteoporosis patients |journal=J. Bone Miner. Res. |volume=13 |issue=7 |pages=1175–82 |year=1998 |pmid=9661082 |doi=10.1359/jbmr.1998.13.7.1175 |url=}}</ref><ref name="pmid10525716">{{cite journal |vauthors=Majumdar S, Link TM, Augat P, Lin JC, Newitt D, Lane NE, Genant HK |title=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 |journal=Osteoporos Int |volume=10 |issue=3 |pages=231–9 |year=1999 |pmid=10525716 |doi= |url=}}</ref><ref name="pmid11905523">{{cite journal |vauthors=Laib A, Newitt DC, Lu Y, Majumdar S |title=New model-independent measures of trabecular bone structure applied to in vivo high-resolution MR images |journal=Osteoporos Int |volume=13 |issue=2 |pages=130–6 |year=2002 |pmid=11905523 |doi=10.1007/s001980200004 |url=}}</ref><ref name="pmid12676974">{{cite journal |vauthors=Boutry N, Cortet B, Dubois P, Marchandise X, Cotten A |title=Trabecular bone structure of the calcaneus: preliminary in vivo MR imaging assessment in men with osteoporosis |journal=Radiology |volume=227 |issue=3 |pages=708–17 |year=2003 |pmid=12676974 |doi=10.1148/radiol.2273020420 |url=}}</ref>


* Studies showed that following antiresorptive therapies, [[Magnetic resonance imaging|MRI]] survey of [[Trabecular bone|trabecular bones]] microstructure is better modality than [[Dual energy X-ray absorptiometry|DXA]] in estimating the treatment efficacy.<ref name="pmid16059627">{{cite journal |vauthors=Chesnut CH, Majumdar S, Newitt DC, Shields A, Van Pelt J, Laschansky E, Azria M, Kriegman A, Olson M, Eriksen EF, Mindeholm L |title=Effects of salmon calcitonin on trabecular microarchitecture as determined by magnetic resonance imaging: results from the QUEST study |journal=J. Bone Miner. Res. |volume=20 |issue=9 |pages=1548–61 |year=2005 |pmid=16059627 |pmc=4445726 |doi=10.1359/JBMR.050411 |url=}}</ref>
* Also, in [[hypogonadism]] men, it seems that [[MRI]] modality with focusing on [[trabecular bone]] structures can show the bone mass loss more reliable than [[Dual energy X-ray absorptiometry|DXA]] method.<ref name="pmid12679429">{{cite journal |vauthors=Benito M, Gomberg B, Wehrli FW, Weening RH, Zemel B, Wright AC, Song HK, Cucchiara A, Snyder PJ |title=Deterioration of trabecular architecture in hypogonadal men |journal=J. Clin. Endocrinol. Metab. |volume=88 |issue=4 |pages=1497–502 |year=2003 |pmid=12679429 |doi=10.1210/jc.2002-021429 |url=}}</ref>
* Typically, due to limitations of [[Signal-to-noise ratio|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 [[Signal-to-noise ratio|SNR]] efficiency is improved and high-resolution [[MRI]] is widely used for [[femoral neck]].<ref name="pmid15999292">{{cite journal |vauthors=Krug R, Banerjee S, Han ET, Newitt DC, Link TM, Majumdar S |title=Feasibility of in vivo structural analysis of high-resolution magnetic resonance images of the proximal femur |journal=Osteoporos Int |volume=16 |issue=11 |pages=1307–14 |year=2005 |pmid=15999292 |doi=10.1007/s00198-005-1907-3 |url=}}</ref>


[[image:Morbus Fabry MRT Osteoporosis.jpg|700px|thumb|center|MRI of osteoporotic fracture in vertebrae; white arrow in pic.C is the site of osteoporotic fracture<br> By Dr Robert CARLIER, CHU Raymond Poincaré, Garches, France. [CC BY 2.0 (http://creativecommons.org/licenses/by/2.0)], ]]
==References==
==References==
{{Reflist|2}}
{{Reflist|2}}
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Latest revision as of 22:15, 7 November 2017

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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

MRI of osteoporotic fracture in vertebrae; white arrow in pic.C is the site of osteoporotic fracture
By Dr Robert CARLIER, CHU Raymond Poincaré, Garches, France. [CC BY 2.0 (http://creativecommons.org/licenses/by/2.0)],

References

  1. 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.
  2. 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.
  3. 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.
  4. 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.
  5. 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.
  6. 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.
  7. 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.
  8. 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.
  9. 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.
  10. 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.