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1H-MR Spectroscopy in the evaluation of osteoporotic and neoplastic vertebral fractures prior percutaneous vertebroplasty 2009

Interventional Spine

Francesco Massari, MD,
Giovanni Simonetti, MD, Non ASSR Member
Salvatore Masala, PhD, ASSR Member
Ludovici Andrea, MD, Non ASSR Member

Scientific Paper

Mentor Award: Yes

Institution where work was conducted

University of Rome “Tor Vergata”, Rome, Italy

Affiliation and Department

Department of Diagnostic and Molecular Imaging, Interventional Radiology and Radiation Therapy

Address

81 Oxford Street
Italy
Rome, Alabama
133
Phone: +39 (339) 2488654
Email: massarimd@gmail.com

Purpose

The detection of spongious vertebral molecular variations can be utilized to distinguish the different sources of bone pathology.The relative water intensity correlates with hematopoietic elements dominating in youth. Instead fat cells proportion increases with age resulting in a conversion of red/yellow marrow.

Methods & Materials

The study was performed with a 3T Magnetic Resonance; we used a single voxel (SV) method (TR/TE 2000/40 msec) with point-resolved spectroscopy sequence (PRESS).We measured % FF and Lipid/Water ratio (LWR) in 46 subjects with MR findings of vertebral fractures related to osteoporosis, multiple myeloma and metastasis. The control group consisted of 48 subjects with no spinal pathologies.

Results

In accordance with the relative presence of fat and water within the vertebral body, we found that in osteoporotic vertebral fracture and in hematopoietic diseases an invertion of physiological LWR is present. This is probably due to intraspongious edema and malignant cells infiltration with replacement of lipid-containing cells.

Conclusion

1H MRS provides a fine evaluation of vertebral bone marrow changes due to primary or secondary pathologies and allows appreciated differences not easily assessable with conventional imaging.
In the upcoming future, MR Spectroscopy may be powerful in identifying physiological as well as pathological biochemical changes in vertebral bone.
This evaluation will be useful in pre-vertebroplasty planning in order to evaluate vertebrae must be treated.

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