title: Diffusion-weighted MRI for detection of hepatic osteodystrophy in primary sclerosing cholangitis: a comparison study with dual-energy X-ray absorptiometry.
abstract: OBJECTIVE
  Osteodystrophy is a frequent complication in primary sclerosing cholangitis (PSC). The aim was to test the feasibility of vertebral bone diffusion-weighted imaging (DWI) in routine liver MRI for detection of osteoporosis using dual-energy X-ray absorptiometry (DXA) as gold standard.
  
  
  METHODS
  Forty PSC patients (50 ± 12.6 years) and ten controls (49.5 ± 13.0 years) were scanned using a DWI spin echo echo-planar sequence (b-factors 0-800 s/mm2) on a 3-T MRI system and DXA (76 kVp). The apparent diffusion coefficient (ADC) and T-score were correlated to laboratory and clinical details using Pearson correlation.
  
  
  RESULTS
  In DXA-diagnosed osteoporosis (n = 3) and osteopenia (n = 12), the mean ADC was decreased (0.26 ± 0.03 and 0.30 ± 0.07 × 10-3mm2/s) compared to patients with normal DXA scan results (n = 25; 0.32 ± 0.06 × 10-3mm2/s). No significant correlation of the ADC and T-score (r = 0.24; p = 0.13) was found, but the T-score correlated significantly to disease duration (r = -0.33; p = 0.04). In patients with prednisolone therapy (n = 7), the DXA T-score was significantly lower (-1.46 ± 0.49 vs. -0.16 ± 0.23; p = 0.03).
  
  
  CONCLUSIONS
  Diffusion-weighted MRI of the vertebral spine is a feasible technic to detect diffusion alterations caused by osteoporosis but lacks diagnostic capacities for diagnosing minor reductions of the bone mineral density detected by DXA.
authors: Department of Diagnostic and Interventional Radiology, University Medical Center Hamburg-Eppendorf (UKE), Martinistr. 52, 20246, Hamburg, Germany. s.keller@uke.de.
authors: Sarah
authors: S
authors: Keller
authors: Department of Diagnostic and Interventional Radiology, University Medical Center Hamburg-Eppendorf (UKE), Martinistr. 52, 20246, Hamburg, Germany.
authors: Harald
authors: H
authors: Ittrich
authors: Department of Internal Medicine, University Medical Center Hamburg-Eppendorf (UKE), Martinistr. 52, 20246, Hamburg, Germany.
authors: Christoph
authors: C
authors: Schramm
authors: Department of Internal Medicine, University Medical Center Hamburg-Eppendorf (UKE), Martinistr. 52, 20246, Hamburg, Germany.
authors: Ansgar W
authors: AW
authors: Lohse
authors: Department of Osteology and Biomechanics, University Medical Center Hamburg-Eppendorf (UKE), Martinistr. 52, 20246, Hamburg, Germany.
authors: Michael
authors: M
authors: Amling
authors: Department of Diagnostic and Interventional Radiology, University Medical Center Hamburg-Eppendorf (UKE), Martinistr. 52, 20246, Hamburg, Germany.
authors: Gerhard
authors: G
authors: Adam
authors: Department of Diagnostic and Interventional Radiology, University Medical Center Hamburg-Eppendorf (UKE), Martinistr. 52, 20246, Hamburg, Germany.
authors: Jin
authors: J
authors: Yamamura
mesh_terms: D015502:Absorptiometry, Photon; D000293:Adolescent; D000328:Adult; D000368:Aged; D015519:Bone Density; D016022:Case-Control Studies; D002648:Child; D015209:Cholangitis, Sclerosing / Q000150:complications*; D038524:Diffusion Magnetic Resonance Imaging; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000000981:diagnostic imaging* / Q000209:etiology*; D013122:Spinal Diseases / Q000000981:diagnostic imaging* / Q000209:etiology*
keywords: Bone mineral density (BMD); Diffusion-weighted imaging (DWI); MRI liver; Osteoporosis; Primary sclerosing cholangitis (PSC)