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

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 = 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.
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.