Application Of Proton Magnetic Resonance Spectroscopy In The Diagnosis Of Osteoporosis

Objective:To evaluate the application value of vertebral proton magnetic resonance spectroscopy (1H-MRS) at3.0Tesla for the assessment of osteoporosis in terms of different age and different bone mass, which provide important data for the future application of1H-MRS in clinical diagnosis of osteoporosis.Methods:1. A total of98females(age range25～76years)were informed consent, divided into three groups:young group(37females, age range25～31years, mean age27years)、middle and old age group(45females, age range51～67years, mean age55years)and osteoporosis group(16females, age range57～76years, mean age61years). All subjects underwent MRI examination. After routine MRI examination (Sagittal T2WI, T1WI and Axial T2WI), single voxel(SV) was chosen for the1H-MRS acquisition at L3vertebral body with PRESS sequence.’H-MRS data was analyzed by SAGE7.0software. The Amp of lipid peak/water peak and lipid peak/water peak Line Width were got. Then the lipid to water ratio (LWR) and fat fraction (FF) were calculated.2. All participants were ruled out metabolic bone diseases, cancer, a history of steroid therapy or other drugs which would influence bone metabolism.3. Statistical analysis was done by SPSS17.0statistical package. P value less than0.05was considered as statistical significance.Results:1. A highly significant positive correlation relationship was found between the LWR、FF and age (r=0.728、0.777, respectively.P=0.000<0.001). A highly significant negative correlation relationship was found between the LW of water and age (r=-0.771,P=0.000<0.001). Also, a negative correlation relationship between the LW of lipid and age was detectable (r=-0.255,P=0.011<0.05)2. The young group mean LWR was6.355,mean FF was0.852;The middle and old age group mean LWR was18.617, mean FF was0.943;The osteoporosis group mean LWR was28.988, mean FF was0.960.LWR and FF of the middle and old age group were significantly higher than that of the young group(P=0.000<0.001).The LWR and FF of vertebral ascended with aging. LWR and FF of the osteoporosis group were significantly higher than that of the middle and old age group(P=0.003<0.01).Fat content of bone marrow increased in the vertebrae of osteoporotic patients.Conclusion:1. FF was on behalf of the content of fat tissue in bone marrow, FF of the middle and old age group and osteoporosis group was significantly higher than that of the young group, and FF of the osteoporosis group was higher than that of the middle and old age group. The FF of vertebral ascended with aging and bone loss.2. LWR of the young group was significantly lower than that of the middle and old age group and osteoporosis group. LWR could be used as a reliable indicator in the evaluation of bone marrow properties and osteoporosis.3. LW of water of the middle and old age group was significantly narrowed than that of the young group, the osteoporosis group was further narrowed than that of the middle and old age group. Suggested that narrowing of the LW of water could predict the reduction of bone density.4.1H-MRS allows noninvasive quantitative bone marrow evaluation of vertebral body, we believe that the use of1H-MRS for osteoporosis assessment is of potentially powerful value.Innovation point:1.1H-MRS has high precision in detecting water and fat content of bone marrow, beneficial to the longitudinal study and drug observation, can be used as an effective approach to evaluate the bone strength changes of osteoporosis patients.2.1H-MRS easily can be added to routine lumbar MRI with little time penalty. Patients of osteoporosis or those in the high risk of osteoporosis brittle-fracture undergoing diagnostic MRI evaluation of the spine can be screened simultaneously for osteoporosis by1H-MRS, which is meaningful for osteoporosis screen and early treatment.