title: Quantitative analysis of vertebral bone marrow perfusion using dynamic contrast-enhanced MRI: initial results in osteoporotic patients with acute vertebral fracture.
abstract: OBJECTIVE
  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.
  
  
  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 = 26) and normal-appearing vertebrae (n = 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 = 15) and quantitative computed tomography (QCT) densitometry (n = 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 normal-appearing 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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Josef Lissner Laboratory for Biomedical Imaging, Institute of Clinical Radiology, University Hospitals Munich-Grosshadern, Germany.
authors.forename: Andreas
authors.initials: A
authors.lastname: Biffar
authors.forename: Gerwin P
authors.initials: GP
authors.lastname: Schmidt
authors.forename: Steven
authors.initials: S
authors.lastname: Sourbron
authors.forename: Melvin
authors.initials: M
authors.lastname: D'Anastasi
authors.forename: Olaf
authors.initials: O
authors.lastname: Dietrich
authors.forename: Mike
authors.initials: M
authors.lastname: Notohamiprodjo
authors.forename: Maximilian F
authors.initials: MF
authors.lastname: Reiser
authors.forename: Andrea
authors.initials: A
authors.lastname: Baur-Melnyk
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001853:Bone Marrow / Q000473:pathology; D003287:Contrast Media / Q000494:pharmacology; D005260:Female; D050815:Fractures, Compression / Q000175:diagnosis / Q000473:pathology*; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods; D007700:Kinetics; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000473:pathology*; D058866:Osteoporotic Fractures / Q000175:diagnosis / Q000473:pathology*; D010477:Perfusion; D016103:Spinal Fractures / Q000473:pathology*; D013131:Spine / Q000473:pathology*
chemical_list: D003287:Contrast Media