Quantitative analysis of vertebral bone marrow perfusion using dynamic contrast‐enhanced MRI : initial results in osteoporotic patients with acute vertebral fracture

Abstract

Purpose: To evaluate the potential of quantitative dynamic contrast-enhanced MRI (DCE-MRI) in vertebral bone marrow (vBM) of patients with acute osteoporotic vertebral compression fractures. Materials and Methods: Twenty-six patients with acute osteoporotic fractures (16 female, 10 male, median age 72, range 48–89) and 10 subjects without known history of osteoporosis (6 female, 4 male, median 65, range 31– 77) were examined 2D-DCE-MRI. Region of interest (ROI) data in fractured (n ¼ 26) and normal-appearing vertebrae (n ¼ 271) were analyzed with a two-compartment tracer-kinetic-model, providing estimates of at least three independent parameters: plasma flow (PF), plasma volume (PV), and extraction flow (EF). Parameters were correlated with dual x-ray absorptiometry (DXA) (n ¼ 15) and quantitative computed tomography (QCT) densitometry (n ¼ 10). Results: Mean PF was significantly higher in fractures than in normal-appearing vertebrae (69.37 vs. 11.72 mL/ 100 mL/min). Similarly, mean PV and EF differed significantly. Mean PF was significantly decreased in normalappearing vBM osteoporotic patients compared to the control group. Mean PF and PV were significantly decreased in lumbar compared to thoracic vertebrae. PV showed a significant correlation with QCT. Conclusion: Perfusion parameters were decreased significantly in normal-appearing vBM of patients. Furthermore, significant perfusion alterations were observed in acute osteoporotic vertebral fractures compared to normal-appearing vertebrae.