7 Tesla MRI of bone microarchitecture discriminates between women without and with fragility fractures who do not differ by bone mineral density

Osteoporosis is a disease of poor bone quality. Bone mineral density (BMD) has limited ability to discriminate between subjects without and with poor bone quality, and assessment of bone microarchitecture may have added value in this regard. Our goals were to use 7 T MRI to: (1) quantify and compare...

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Bibliographic Details
Published in:Journal of bone and mineral metabolism 2015-05, Vol.33 (3), p.285-293
Main Authors: Chang, Gregory, Honig, Stephen, Liu, Yinxiao, Chen, Cheng, Chu, Kevin K., Rajapakse, Chamith S., Egol, Kenneth, Xia, Ding, Saha, Punam K., Regatte, Ravinder R.
Format: Article
Language:English
Subjects:
Aged
Bone and Bones
Bone Density - physiology
Case-Control Studies
Female
Femur - pathology
Fractures, Bone - pathology
Humans
Magnetic Resonance Imaging - methods
Medicine
Medicine & Public Health
Metabolic Diseases
Middle Aged
Original Article
Orthopedics
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Summary:Osteoporosis is a disease of poor bone quality. Bone mineral density (BMD) has limited ability to discriminate between subjects without and with poor bone quality, and assessment of bone microarchitecture may have added value in this regard. Our goals were to use 7 T MRI to: (1) quantify and compare distal femur bone microarchitecture in women without and with poor bone quality (defined clinically by presence of fragility fractures); and (2) determine whether microarchitectural parameters could be used to discriminate between these two groups. This study had institutional review board approval, and we obtained written informed consent from all subjects. We used a 28-channel knee coil to image the distal femur of 31 subjects with fragility fractures and 25 controls without fracture on a 7 T MRI scanner using a 3-D fast low angle shot sequence (0.234 mm × 0.234 mm × 1 mm, parallel imaging factor = 2, acquisition time = 7 min 9 s). We applied digital topological analysis to quantify parameters of bone microarchitecture. All subjects also underwent standard clinical BMD assessment in the hip and spine. Compared to controls, fracture cases demonstrated lower bone volume fraction and markers of trabecular number, plate-like structure, and plate-to-rod ratio, and higher markers of trabecular isolation, rod disruption, and network resorption ( p   0.05). In receiver-operating-characteristics analyses, microarchitectural parameters could discriminate cases and controls (AUC = 0.66–0.73, p  
ISSN:0914-8779
1435-5604
DOI:10.1007/s00774-014-0588-4