title: Evaluation of trabecular microarchitecture in nonosteoporotic postmenopausal women with and without fracture.
abstract: This study compared microscopic magnetic resonance imaging (µMRI) parameters of trabecular microarchitecture between postmenopausal women with and without fracture who have normal or osteopenic bone mineral density (BMD) on dual-energy X-ray absorptiometry (DXA). It included 36 postmenopausal white women 50 years of age and older with normal or osteopenic BMD (T-scores better than -2.5 at the lumbar spine, proximal femur, and one-third radius on DXA). Eighteen women had a history of low-energy fracture, whereas 18 women had no history of fracture and served as an age, race, and ultradistal radius BMD-matched control group. A three-dimensional fast large-angle spin-echo (FLASE) sequence with 137 µm × 137 µm × 400 µm resolution was performed through the nondominant wrist of all 36 women using the same 1.5T scanner. The high-resolution images were used to measure trabecular bone volume fraction, trabecular thickness, surface-to-curve ratio, and erosion index. Wilcoxon signed-rank tests were used to compare differences in BMD and µMRI parameters between postmenopausal women with and without fracture. Post-menopausal women with fracture had significantly lower (p < 0.05) trabecular bone volume fraction and surface-to-curve ratio and significantly higher (p < 0.05) erosion index than postmenopausal women without fracture. There was no significant difference between postmenopausal women with and without fracture in trabecular thickness (p = 0.80) and BMD of the spine (p = 0.21), proximal femur (p = 0.19), one-third radius (p = 0.47), and ultradistal radius (p = 0.90). Postmenopausal women with normal or osteopenic BMD who had a history of low-energy fracture had significantly different (p < 0.05) µMRI parameters than an age, race, and ultradistal radius BMD-matched control group of postmenopausal women with no history of fracture. Our study suggests that µMRI can be used to identify individuals without a DXA-based diagnosis of osteoporosis who have impaired trabecular microarchitecture and thus a heretofore-unappreciated elevated fracture risk.
authors.affiliation: Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin 53792-3252, USA. r.kijowski@hosp.wisc.edu
authors.forename: Richard
authors.initials: R
authors.lastname: Kijowski
authors.forename: Michael
authors.initials: M
authors.lastname: Tuite
authors.forename: Diane
authors.initials: D
authors.lastname: Kruger
authors.forename: Alejandro
authors.initials: A
authors.lastname: Munoz Del Rio
authors.forename: Michael
authors.initials: M
authors.lastname: Kleerekoper
authors.forename: Neil
authors.initials: N
authors.lastname: Binkley
mesh_terms: D000368:Aged; D015519:Bone Density; D001842:Bone and Bones / Q000473:pathology*; D005260:Female; D017102:Fracture Healing; D050723:Fractures, Bone / Q000517:prevention & control* / Q000628:therapy; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging / Q000379:methods; D008875:Middle Aged; D010024:Osteoporosis; D010865:Pilot Projects; D017698:Postmenopause; D011446:Prospective Studies; D012306:Risk