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An [[MRI]] provides a microstructural detail of the bone. It is very helpful in vertebral [[compression fracture]]s.  The short tau inversion recovery (STIR) sequence of an MRI is very sensitive for detecting vertebral [[edema]], which results from fresh fractures or micro-fractures.
An [[MRI]] provides a microstructural detail of the bone. It is very helpful in vertebral [[compression fracture]]s.  The short tau inversion recovery (STIR) sequence of an MRI is very sensitive for detecting vertebral [[edema]], which results from fresh fractures or micro-fractures.


==MRI==
==Osteoporosis MRI==
Indications for [[MRI]] include:
* 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 consist of trabecular bones, but they have highest impression from metabolic stimuli; thus, in contrast with DXA which is measure both trabecular and cortical at the same time, MRI would be 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 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 precise.<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 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.<ref name="pmid18034342" />
* [[Adrenal]] tumors
* Although the use of MRI is growing due to relatively good quantitative measurement of trabecular bones and bone strength in contrast with dual X-ray absorbtiometery (DXA), but it is not expected to osteoporosis survey by DXA become changed. Considerable effect of MRI use on osteoporosis may include:
* Metabolic [[bone]] disease
*# Complementary with ordinary DXA
 
*# Treatment response survey in high-risk groups
*# Schedule combination treatment protocols<ref name="pmid18034342" />
* 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.<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>
* Studies showed that, following antiresorptive therapies, MRI survey of trabecular bones microstructure is better modality than 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 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 (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 body (e.g., lumbar spine and femoral neck); therefore, recently 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>
==References==
==References==
{{Reflist|2}}
{{Reflist|2}}

Revision as of 16:44, 8 August 2017

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Cafer Zorkun, M.D., Ph.D. [2], Raviteja Guddeti, M.B.B.S.[3]

Overview

An MRI provides a microstructural detail of the bone. It is very helpful in vertebral compression fractures. The short tau inversion recovery (STIR) sequence of an MRI is very sensitive for detecting vertebral edema, which results from fresh fractures or micro-fractures.

Osteoporosis 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 consist of trabecular bones, but they have highest impression from metabolic stimuli; thus, in contrast with DXA which is measure both trabecular and cortical at the same time, MRI would be 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 precise.[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]
  • Although the use of MRI is growing due to relatively good quantitative measurement of trabecular bones and bone strength in contrast with dual X-ray absorbtiometery (DXA), but it is not expected to osteoporosis survey by DXA become changed. Considerable effect of MRI use on osteoporosis may include:
    1. Complementary with ordinary DXA
    2. Treatment response survey in high-risk groups
    3. Schedule combination treatment protocols[1]
  • 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]
  • Studies showed that, following antiresorptive therapies, MRI survey of trabecular bones microstructure is better modality than DXA in estimating the treatment efficacy.[4]
  • 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.[5]
  • 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 body (e.g., lumbar spine and femoral neck); therefore, recently SNR efficiency is improved and high-resolution MRI is widely used for femoral neck.[6]

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. 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.
  5. 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.
  6. 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.

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