Download PDF
Aktuelle Rheumatologie 2002; 27(6): 341-346
DOI: 10.1055/s-2002-36450
Originalarbeit
© Georg Thieme Verlag Stuttgart · New York

Magnetresonanztomographie in der Diagnostik der Osteoporose

Magnetic Resonance Tomography in the Diagnosis of OsteoporosisT.  M.  Link1
  • 1Institut für Röntgendiagnostik der Technischen Universität München
Further Information

Publication History

Publication Date:
08 January 2003 (online)

Also available at
    Permissions and Reprints

Zusammenfassung

Neben den etablierten Knochendichtemessverfahren werden neue Verfahren zur Charakterisierung der Trabekelstruktur entwickelt. Die magnetresonanztomographischen Verfahren basieren zum einen auf der hochauflösenden Darstellung des trabekulären Knochens und zum anderen auf der Bestimmung der T2*-Relaxationszeit, die in Abhängigkeit von der Dichte des Trabekelskeletts mehr oder weniger stark verkürzt wird. Die hochauflösenden MR-tomographischen Verfahren haben sich in klinischen Studien dem Standardverfahren, der Knochendichte, als gleichwertig erwiesen und liefern darüber hinaus komplementäre Informationen zur Osteoporosediagnostik. Derzeit sind diese Verfahren noch als Forschungsinstrumente zu werten, mit der Verbesserung der MR-Technik ist aber der Einsatz dieser hochauflösenden Methoden zur Strukturanalyse des Knochens auch bei besonderen Fragestellungen im Rahmen klinischer Untersuchungen möglich.

Abstract

New methods for characterising the trabecular structure are being developed alongside the traditional methods for bone density measurement. MRI methods are based on the one hand on the high-resolution imaging of the trabecular bone and on the other hand on determining the T2* relaxation time which is shortened more or less pronouncedly depending on the density of the trabecular skeleton. These high-resolution MRI methods have proved to be equal to the standard bone density measurement procedures in clinical studies. What is more, they also furnish complementary information on the diagnosis of osteoporosis. At present the MRI methods are considered to be research tools. However, as these high-resolution methods for bone structure analysis are being improved by an even more refined MR technique they will become increasingly useful in solving specific problems within the framework of clinical examinations.

Literatur

  • 1 Consensus Development Conference . Diagnosis, prophylaxis, and treatment of osteoporosis.  Am J Med. 1993;  94 646-650
    CrossrefPubMedGoogle Scholar
  • 2 NIH Consensus Development Panel on Osteoporosis Prevention and Therapy . Osteoporosis prevention, diagnosis, and therapy.  JAMA. 2001;  285 785-795
    CrossrefPubMedGoogle Scholar
  • 3 Online NCS .Osteoporosis Prevention, Diagnosis, and Therapy. March 27-29 (17). 2000: 1-36
    Google Scholar
  • 4 Felsenberg D, Glüer C. Bildgebende Verfahren, Knochendichtemessung und quantitativer Ultraschall.  Akt Rheumatol. 2001;  26 106-114
    Google Scholar
  • 5 Lespessailles E, Roux J, Benhamou C, Arlot M, Eynard E, Harba R, Padonou C, Meunier P. Fractal analysis of bone texture on os calcis radiographs compared with trabecular microarchitecture analyzed by histomorphometry.  Calcif Tissue Int. 1998;  63 121-125
    CrossrefPubMedGoogle Scholar
  • 6 Caligiuri P, Giger M L, Favus M. Multifractal radiographic analysis of osteoporosis.  Med Phys. 1994;  21 503-508
    PubMedGoogle Scholar
  • 7 Caligiuri P, Giger M, Favus M, Jia H, Doi K, Dixon L. Computerized radiographic analysis of osteoporosis: preliminary evaluation.  Radiology. 1993;  186 471-474
    PubMedGoogle Scholar
  • 8 Benhamou C, Lespessailes E, Touliere D, Jacquet G, Harba R, Jennane R. Fractal evaluation of trabecular bone microarchitecture: Comparative study of calcaneus and ultradistal radius.  J Bone Miner Res. 1993;  8 263
    PubMedGoogle Scholar
  • 9 Chevalier F, Laval-Jeantet A, Laval-Jeantet M, Bergot C. CT image analysis of the vertebral trabecular network in vivo.  Calcif Tissue Int. 1992;  51 8-13
    CrossrefPubMedGoogle Scholar
  • 10 Durand E, Rügsegger P. High-contrast resolution of CT images for bone structure analysis.  Med Phys. 1992;  19 569-573
    CrossrefPubMedGoogle Scholar
  • 11 Durand E, Ruegsegger P. Cancellous bone structure: analysis of high-resolution CT images with the run-length method.  J Comput Assist Tomogr. 1991;  15 133-139
    PubMedGoogle Scholar
  • 12 Ito M, Ohki M, Hayashi K, Yamada M, Uetani M, Nakamura T. Trabecular texture analysis of CT images in the relationship with spinal fracture.  Radiology. 1995;  194 55-59
    PubMedGoogle Scholar
  • 13 Muller R, Hildebrand T, Hauselmann H, Ruegsegger P. In vivo reproducibility of three-dimensional structural properties of noninvasive bone biopsies using 3D-pQCT.  J Bone Miner Res. 1996;  11 1745-1750
    PubMedGoogle Scholar
  • 14 Ruegsegger P, Koller B, Muller R. A microtomographic system for the nondestructive evaluation of bone architecture.  Calcif Tissue Int. 1996;  58 24-29
    CrossrefPubMedGoogle Scholar
  • 15 Majumdar S, Newitt D, Jergas M, Gies A, Chiu E, Osman D, Keltner J, Keyak J, Genant H. Evaluation of technical factors affecting the quantification of trabecular bone structure using magnetic resonance imaging.  Bone. 1995;  17 417-430
    CrossrefPubMedGoogle Scholar
  • 16 Majumdar S, Newitt D, Mathur A, Osman D, Gies A, Chiu E, Lotz J, Kinney J, Genant H. Magnetic resonance imaging of trabecular bone structure in the distal radius: Relationship with X-ray tomographic microscopy and biomechanics.  Osteoporos Int. 1996;  6 376-385
    CrossrefPubMedGoogle Scholar
  • 17 Hipp J, Jansujwicz A, Simmons C, Snyder B. Trabecular Bone Morphology from Micro-Magnetic Resonance Imaging.  J Bone Miner Res. 1996;  11 286-292
    PubMedGoogle Scholar
  • 18 Vieth V, Link T M, Lotter A, Persigehl T, Newitt D, Heindel W, Majumdar S. Does the trabecular structure depicted by high resolution MRI of the calcaneus reflect the true bone structure?.  Invest Radiol. 2001;  36 210-217
    CrossrefPubMedGoogle Scholar
  • 19 Link T M, Majumdar S, Lin J, Newitt D, Augat P, Ouyang X, Mathur A, Genant H. A comparative study of trabecular bone properties in the spine and femur using high resolution MRI and CT.  J Bone Miner Res. 1998;  13 122-132
    CrossrefPubMedGoogle Scholar
  • 20 Majumdar S, Kothari M, Augat P, Newitt D, Link T, Lin J, Genant H. High Resolution Magnetic Resonance (MR): Three Dimensional (3D) Trabecular bone architecture and biomechanical properties.  Bone. 1998;  22 445-454
    CrossrefPubMedGoogle Scholar
  • 21 Link T M, Majumdar S, Augat P, Lin J, Newitt D, Lu Y, Lane N, Genant H. In Vivo High Resolution MRI of the Calcaneus: Differences in trabecular structure in osteoporosis patients.  J Bone Miner Res. 1998;  13 1175-1182
    CrossrefPubMedGoogle Scholar
  • 22 Link T M, Lotter A, Beyer F, Christiansen S, Newitt D, Lu Y, Schmid C, Majumdar S. Post-Cardiac Transplantation Changes in Calcaneal Trabecular Bone Structure: A Magnetic Resonance Imaging Study.  Radiology. 2000;  217 855-862
    CrossrefPubMedGoogle Scholar
  • 23 Link T M, Saborowski S, Kisters K, Kempkes M, Kosch M, Newitt D, Lu Y, Waldt S, Majumdar S. Changes in Calcaneal Trabecular Bone Structure Assessed with High Resolution MRI in Patients With Kidney Transplantation.  Osteoporos Int. 2002;  2002 119-129
    PubMedGoogle Scholar
  • 24 Link T M, Vieth V, Matheis J, Newitt D, Lu Y, Rummeny E J, Majumdar S. Bone structure of the distal radius and the calcaneus versus BMD of the spine and proximal femur in the prediction of osteoporotic spine fractures.  Eur Radiol. 2002;  12 401-408
    CrossrefPubMedGoogle Scholar
  • 25 Majumdar S, Link T M, Augat P, Lin J, Newitt D, Lane N, Genant H. Trabecular bone architecture in the distal radius using MR imaging in subjects with fractures of the proximal femur.  Osteoporos Int. 1999;  10 231-239
    CrossrefPubMedGoogle Scholar
  • 26 Wehrli F, Hwang S, Ma J, Song H, Ford J, Haddad J. Cancellous bone volume and structure in the forearm: Noninvasive assessment with MR microimaging and image processing.  Radiology. 1998;  206 347-357
    PubMedGoogle Scholar
  • 27 Wehrli F, Gomberg B, Saha P, Song H, Hwang S, Snyder P. Digital topological analysis of in vivo magnetic resonance microimages of trabecular bone reveals structural implications of osteoporosis.  J Bone Miner Res. 2001;  16 1520-1531
    CrossrefPubMedGoogle Scholar
  • 28 Majumdar S, Thomasson D, Shimakawa A, Genant H. Quantitation of the susceptibility difference between trabecular bone and bone marrow: experimental studies.  Magn Res Med. 1991;  22 111-127
    PubMedGoogle Scholar
  • 29 Majumdar S, Genant H K. In vivo relationship between marrow T2* and trabecular bone density determined with a chemical shift-selective asymmetric spin-echo sequence.  J Magn Reson Imaging. 1992;  2 209-219
    PubMedGoogle Scholar
  • 30 Brismar T B, Karlsson M, Li T, Ringertz H. The correlation between R2 and bone mineral measurements in human vertebrae: an in vitro study.  Eur Radiol. 1999;  9 141-144
    CrossrefPubMedGoogle Scholar
  • 31 Brismar T B, Hindmarsh T, Ringertz H. Experimental correlation between T2* and ultimate compressive strength in lumbar porcine vertebrae.  Acad Radiol. 1997;  4 426-430
    PubMedGoogle Scholar
  • 32 Wehrli F W, Ford J C, Attie M, Kressel H Y, Kaplan F S. Trabecular structure: preliminary application of MR interferometry.  Radiology. 1991;  179 615-621
    PubMedGoogle Scholar
  • 33 Funke M, Bruhn H, Vosshenrich R, Rudolph O, Grabbe E. Bestimmung der T2*-Relaxationszeit zur Charakterisierung des trabekulären Knochens.  Fortschr Röntgenstr. 1994;  161 58-63
    PubMedGoogle Scholar
  • 34 Grampp S, Majumdar S, Jergas M, Newitt D, Lang P, Genant H. Distal Radius: In vivo assessment with quantitative MR Imaging, peripheral quantitative CT and Dual X-ray Absorptiometry.  Radiology. 1996;  198 213-218
    PubMedGoogle Scholar
  • 35 Link T M, Majumdar S, Augat P, Lin J, Newitt D, Lu Y, Lane N, Genant H. MRI T2* Decay Characteristics of the Proximal Femur for Assessment of Osteoporosis and Fracture Discrimination.  Radiology. 1998;  209 531-536
    CrossrefPubMedGoogle Scholar
  • 36 Caldwell C, Moran E, Bogoch E. Fractal dimension as a measure of altered trabecular bone in experimental inflammatory arthritis.  J Bone Miner Res. 1998;  13 978-985
    PubMedGoogle Scholar
  • 37 Mawatari T, Miura H, Higaki H, Kurata K, Moro-oka T, Murakami T, Iwamoto Y. Quantitative analysis of three-dimensional complexity and connectivity changes in trabecular microarchitecture in relation to aging, menopause, and inflammation.  J Orthop Sci. 1999;  4 431-438
    CrossrefPubMedGoogle Scholar
  • 38 Buckland-Wright J, Lynch J, Bird C. Microfocal techniques in quantitative radiography: measurement of cancellous bone organization.  Br J Rheumatol. 1996;  35 18-22
    PubMedGoogle Scholar
  • 39 Boehm H, Raeth C, Newitt D, Majumdar S, Link T. Local 3D scaling properties - a new structure parameter for the analysis of trabecular bone in high resolution MRI: comparison with BMD in the prediction of biomechanical strength in vitro.  Invest Radiol. 2003;  (im Druck)
    PubMedGoogle Scholar
  • 40 Laib A, Barou O, Vico L, Lafage-Proust M, Alexandre C, Rugsegger P. 3D microcomputed tomography of trabecular and cortical bone architecture with application to a rat model of immobilisation osteoporosis.  Med Biol Eng Comput. 2000;  38 326-332
    PubMedGoogle Scholar
  • 41 Newitt D, Majumdar S, van Rietbergen B, von Ingersleben G, Harris S, Genant H, Chesnut C, Garnero P, MacDonald B. In vivo assessment of architecture and microfinite element analysis derived indices of mechanical properties of trabecular bone in the radius.  Osteoporos Int. 2002;  13 6-17
    CrossrefPubMedGoogle Scholar
  • 42 Newitt D, van Riethbergen B, Majumdar S. Processing and analysis of in vivo high-resolution MR images of trabecular bone for longitudinal studies: reproducibility of structural measures and micro-finite element analysis derived mechanical properties.  Osteoporos Int. 2002;  13 278-287
    CrossrefPubMedGoogle Scholar

PD Dr. med. T. M. Link

Institut für Röntgendiagnostik der Technischen Universität München

Ismaningerstraße 22 · 81675 München

Phone: 089/4140-2621

Fax: 089/4140-4834 ·

Email: tmlink@roe.med.tu-muenchen.de

      >