Investigative Magnetic Resonance Imaging

Korean Society of Magnetic Resonance in Medicine (대한자기공명의과학회)
권호 표지

Correlation Between Vertebral Marrow Fat Fraction Measured Using Dixon Quantitative Chemical Shift MRI and BMD Value on Dual-energy X-ray Absorptiometry

Dixon 정량 화학적 변위 자기공명영상을 이용한 척추 골수 지방함량과 이중에너지 방사선 흡수법의 BMD 값의 비교

  • Youn, In-Young (Department of Radiology, Chung-Ang University Medical Center, Chung-Ang University College of Medicine) ;
  • Lee, Hwa-Yeon (Department of Radiology, Chung-Ang University Medical Center, Chung-Ang University College of Medicine) ;
  • Kim, Jae-Kyun (Department of Radiology, Chung-Ang University Medical Center, Chung-Ang University College of Medicine)
  • 윤인영 (중앙대학교 의과대학 중앙대학교병원 영상의학과) ;
  • 이화연 (중앙대학교 의과대학 중앙대학교병원 영상의학과) ;
  • 김재균 (중앙대학교 의과대학 중앙대학교병원 영상의학과)
  • Received : 2011.08.09
  • Accepted : 2011.11.30
  • Published : 2012.04.30
Download PDF
⟨ Previous Next ⟩

Abstract

Purpose : The purpose of this study was to determine whether there is a significant correlation between vertebral marrow fat fraction measured using Dixon quantitative chemical shift MRI (QCSI) and BMD on dual-energy X-ray absorptiometry (DXA). Materials and Methods: This retrospective study included 68 healthy individuals [mean age, 50.7 years; range, 25-76; male/female (M/F) = 36/32] who underwent DXA of the L-spine and whole body MRI including QCSI of the L-spine and chemical shift MRI of the liver. The enrolled individuals were divided into subgroups according to sex and T-score [i.e., normal bone density (M/F=27/23) and osteopenia (M/F=9/9)]. Vertebral marrow (Dixon QCSI, TR/TE 10.2/4.8 ms) and hepatic fat fractions (chemical shift technique, TR/TE 110/4.9 and 2.2 ms) were calculated on MRI. We evaluated whether there were significant differences in age, body mass index (BMI), vertebral marrow fat fraction, or hepatic fat fraction among the subgroups. Whether or not the participant had reached menopause was also evaluated in females. The correlations among variables (i.e., age, BMI, vertebral marrow and hepatic fat fractions, BMD) were evaluated using Spearman's correlation method. Results: There were no significant differences in age, BMI, or vertebral marrow and hepatic fat fractions between the two male subgroups (normal bone density vs. osteopenia). In female subjects, mean age in the osteopenic subgroup was greater than that in the normal subgroup (p=0.01). Presence of menopause was more common in the osteopenic subgroup [77.8% (7/9)] than the normal subgroup [26.1% (6/23), p<0.05]. The other variables showed no significant difference between female subgroups. The only significant correlation with marrow fat fraction after partial correlation analysis was that with age in the female subjects (r=0.43, p<0.05). Conclusion: The vertebral marrow fat fraction calculated using the Dixon QCSI does not precisely reflect the mild decrease in BMD for either sex.

목적: Dixon 정량 화학적 변위 자기공명영상(QCSI)의 척추 골수 지방함량과 이중에너지 방사선 흡수법 (DXA)를 통한 BMD 값과의 상관성을 알아본다. 대상과 방법: QCSI와 간의 화학적 변위영상을 포함한 전신 자기공명영상(MRI)과 요추의 DXA를 시행한 68명의 건강한 사람들[평균연령, 50.7세; 범위, 25-76세; 남/여=36/32]을 대상으로 후향적 연구를 시행하였다. 성별과 T-score에 따라 정상(남/여=27/23)과 골감소증(남/여=9/9)집단으로 나누고, MRI로 척추골수와 간의 지방함량을 측정하였다. 각 집단의 나이, 체질량지수(BMI), 골수 지방함량과 간의 지방함량을 비교하였고, 여성에서는 폐경 전후 각 변수들의 비교를 추가하여 Spearman's 상관계수로 평가하였다. 결과: 남성의 나이, BMI, 척추 골수와 간의 지방함량은 정상과 골감소증 집단 사이에 큰 차이를 보이지 않았다. 여성에서는, 골감소증 집단의 평균 나이가 정상집단에 비해 높았고(p=0.01), 폐경된 경우가 많았으나[폐경 전, 26.1%(6/23); 후, 77.8%(7/9); p<0.05], 다른 변수들은 유의한 차이를 보이지 않았다. 골수 지방함량과의 비교에 있어 여성의 나이는 유일한 의미 있는 변수였다(r=0.43, p<0.05). 결론: Dixon QCSI를 통한 척추 골수 지방함량의 측정은 남녀 모두에 있어 DXA BMD 감소를 정확히 반영하지는 않는다.

Keywords

References

  1. Griffith JF, Yeung DK, Antonio GE, et al. Vertebral marrow fat content and diffusion and perfusion indexes in women with varying bone density: MR evaluation. Radiology 2006;241:831-838
  2. Bauer, JS and TM Link. Advances in osteoporosis imaging. Eur J Radiol 2009;71:440-449
  3. Griffith JF, Yeung DK, Antonio GE, et al. Vertebral bone mineral density, marrow perfusion, and fat content in healthy men and men with osteoporosis: dynamic contrast-enhanced MR imaging and MR spectroscopy. Radiology 2005;236:945-951
  4. Tang GY, Lv zw, Tang RB, et al. Evaluation of MR spectroscopy and diffusion-weighted MRI in detecting bone marrow changes in postmenopausal women with osteoporosis. Clin Radiol 2010;65:377-381
  5. Wehrli FW. Structural and functional assessment of trabecular and cortical bone by micro magnetic resonance imaging. J Magn Reson Imaging 2007;25:390-409
  6. Cassidy FH, Yokoo T, Aganovic L, et al. Fatty liver disease: MR imaging techniques for the detection and quantification of liver steatosis. Radiographics 2009;29:231-260
  7. Gokalp G, Mutlu FS, Yazici Z, et al. Evaluation of vertebral bone marrow fat content by chemical-shift MRI in osteoporosis. Skeletal Radiol 2011;40:577-585
  8. Lewiecki EM and J.L. Borges, Bone density testing in clinical practice. Arq Bras Endocrinol Metabol 2006;50:586-595
  9. Kanis JA. Assessment of fracture risk and its application to screening for postmenopausal osteoporosis: synopsis of a WHO report. WHO Study Group. Osteoporos Int 1994;4:368-381
  10. Bley TA, Wieben O, François CJ, et al. Fat and water magnetic resonance imaging. J Magn Reson Imaging 2010;31:4-18
  11. van der Poorten D, Milner KL, Hui J, et al. Visceral fat: a key mediator of steatohepatitis in metabolic liver disease. Hepatology 2008;48:449-457
  12. Maas M, Akkerman EM, Venema HW, Stoker J, Den Heeten GJ. Dixon quantitative chemical shift MRI for bone marrow evaluation in the lumbar spine: a reproducibility study in healthy volunteers. J Comput Assist Tomogr 2001;25:691-697
  13. Ma X, Holalkere NS, Kambadakone RA, et al. Imaging-based quantification of hepatic fat: methods and clinical applications. Radiographics 2009;29:1253-1277
  14. Griffith JF, Yeung DK, Leung JC, et al. Prediction of bone loss in elderly female subjects by MR perfusion imaging and spectroscopy. Eur Radiol 2011;21:1160-1169
  15. Rosen CJ and A, Klibanski, Bone, fat, and body composition: evolving concepts in the pathogenesis of osteoporosis. Am J Med 2009;122:409-414
  16. Meunier P, Aaron J, Edouard C, Vignon G. Osteoporosis and the replacement of cell populations of the marrow by adipose tissue. A quantitative study of 84 iliac bone biopsies. Clin Orthop Relat Res 1971;80:147-154
  17. Justesen J, Stenderup K, Ebbesen EN, Mosekilde L, Steiniche T, Kassem M. Adipocyte tissue volume in bone marrow is increased with aging and in patients with osteoporosis. Biogerontology 2001;2:165-171
  18. Gerard EL, Ferry JA, Amrein PC, et al. Compositional changes in vertebral bone marrow during treatment for acute leukemia: assessment with quantitative chemical shift imaging. Radiology 1992;183:39-46
  19. Maas M, van Kuijk C, Stoker J, et al. Quantification of bone involvement in Gaucher disease: MR imaging bone marrow burden score as an alternative to Dixon quantitative chemical shift MR imaging-initial experience. Radiology 2003;229:554-561
  20. Wismer GL, Rosen BR, Buxton R, et al. Chemical shift imaging of bone marrow: preliminary experience. AJR Am J Roentgenol 1985;145:1031-1037
  21. Ishijima H, et al. Water fraction of lumbar vertebral bone marrow estimated from chemical shift misregistration on MR imaging: normal variations with age and sex. AJR Am J Roentgenol 1996;167:355-358
  22. Liney GP, Bernard CP, Manton DJ, Turnbull LW, Langton CM. Age, gender, and skeletal variation in bone marrow composition: a preliminary study at 3.0 Tesla. J Magn Reson Imaging 2007;26:787-793
  23. Schellinger D, Lin CS, Lim J, Hatipoglu HG, Pezzullo JC, Singer AJ. Bone marrow fat and bone mineral density on proton MR spectroscopy and dual-energy X-ray absorptiometry: their ratio as a new indicator of bone weakening. AJR Am J Roentgenol 2004;183:1761-1765
  24. Schellinger D, Lin CS, Hatipoglu HG, Fertikh D. Potential value of vertebral proton MR spectroscopy in determining bone weakness. AJNR Am J Neuroradiol 2001;22:1620-1627
  25. Shen W, Chen J, Punyanitya M, Shapses S, Heshka S, Heymsfield SB. MRI-measured bone marrow adipose tissue is inversely related to DXA-measured bone mineral in Caucasian women. Osteoporos Int 2007;18:641-647
  26. Bredella MA, et al. Vertebral bone marrow fat is positively associated with visceral fat and inversely associated with IGF-1 in obese women. Obesity (Silver Spring), 2010
  27. Gilsanz V, Chalfant J, Mo AO, Lee DC, Dorey FJ, Mittelman SD. Reciprocal relations of subcutaneous and visceral fat to bone structure and strength. J Clin Endocrinol Metab 2009;94:3387-3393
  28. Levenson H, et al. Fatty infiltration of the liver: quantification with phase-contrast MR imaging at 1.5 T vs biopsy. AJR Am J Roentgenol 1991;156:307-312
  29. Koda M, Kawakami M, Murawaki Y, et al. The impact of visceral fat in nonalcoholic fatty liver disease: cross-sectional and longitudinal studies. J Gastroenterol 2007;42:897-903