A new diagnostic score to detect osteoporosis in patients undergoing lumbar spine MRI

Bandirali, Michele; Leo, Giovanni Di; Papini, Giacomo Davide Edoardo; Messina, Carmelo; Sconfienza, Luca Maria; Ulivieri, Fabio Massimo; Sardanelli, Francesco

doi:10.1007/s00330-015-3699-y

Cited by 90 publications

(51 citation statements)

References 33 publications

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“…We agreed with a study done by Bandirali et al [10] in the main concept and high sensitivity and specificity of M-score with its high utility as a screening tool. Our study revealed sensitivity and specificity values around 93% and 84%, respectively, of M-score correlated with DEXA examination as a reference gold standard.…”

Section: Discussionsupporting

confidence: 91%

“…Moreover, osteoporosis-related fragility fractures may be accurately detected by MRI as shown by Bazzocchi et al [12]. Only one study by Bandirali et al [10] had previously aimed to define a new quantitative lumbar spine MRI-based method on standard T1-weighted images for diagnosing osteoporosis.…”

Section: Discussionmentioning

confidence: 99%

“…The diagnostic performance of SNR L1-L4 was estimated for each patient and used to obtain M-score (MRI-based score) for the diagnosis of osteoporosis. The SNR L1-L4 of the control group was also used in the equation by using their mean (SNR ref ) and standard deviation (SD ref ) [10].…”

Section: Mri Image Analysismentioning

confidence: 99%

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Role of lumbar spine signal intensity measurement by MRI in the diagnosis of osteoporosis in post-menopausal women

Saad

Ahmed

Mohamed

et al. 2019

Egypt J Radiol Nucl Med

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Background: Osteoporosis is a worldwide health problem and a common cause of bone fractures; the most common type of osteoporosis is post-menopausal type. MRI has a role in the diagnosis of osteoporosis and can be used as a screening tool, so the purpose of our study was to define a quantitative MRI-based score (M-score) for the detection of lumbar spine osteoporosis and to evaluate the correlation between lumbar spine signal intensity measured by MRI and BMD (bone mineral density) in post-menopausal women. Our case-control study involved 100 cases (50 old post-menopausal females as a case group and 50 healthy females as a control group of matched age). Both groups were subjected to history taking, dual-energy X-ray absorptiometry (DEXA), and conventional lumbar MRI. DEXA was performed for the lumbar spine and all scores (T-score, Z-score, BMD) were calculated. Lumbar MRI was performed (sagittal T1WI and T2WI) from L1-L4 levels. SNR L1-L4 and M-score were calculated from T1W images. Results: All DEXA scores were significantly lower in post-menopausal females compared to the control group (P < 0.0001). Meanwhile, SNR L1-L4 and M-score were significantly higher among cases than controls (P < 0.0001). The diagnostic threshold of SNR L1-L4 and M-score for distinguishing osteoporotic from non-osteoporotic females was 104.5 for SNR L1-L4 with a sensitivity of 94%, specificity 60%, positive predictive values (PPV) 31%, and negative predictive values (NPV) 98%, and 3.5 for M-score with a sensitivity of 93.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

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Role of lumbar spine signal intensity measurement by MRI in the diagnosis of osteoporosis in post-menopausal women

Saad

Ahmed

Mohamed

et al. 2019

Egypt J Radiol Nucl Med

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“…Furthermore, we can infer the status of underlying bone and its strength. [12] MRI may noninvasively provide an insight into the changes occurring in vertebral marrow with age and menopause defining marrow fat proportions. Recent studies with MRS and quantitative diffusion have shown that there is an increased amount of fat in the vertebral marrow in patients with osteoporosis, indirectly reflecting sparsity of bone trabeculae and decreased bone mineral density.…”

Section: Discussionmentioning

confidence: 99%

To study the role of various magnetic resonance imaging sequences in assessment of vertebral marrow changes in postmenopausal Indian female population

Wahab¹,

Ahmad²

2017

JMRPS

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Background: Magnetic resonance imaging (MRI) appearance of vertebral bone marrow is highly variable varying with age and menopause in females. The differential appearance of marrow on various sequences can be used for assessing the marrow and studying the changes which are physiological with age and the changes which represent pathology. Objective: The aim and purpose of this study is to evaluate the patterns of changes in the appearance of vertebral bone marrow occurring with age and menopause in Indian females on MRI. Materials and Methods: MRI images of 60 female subjects −0.30 pre-menopausal females more than 25 years (25-35 and 35-45 years age group) and 30 post-menopausal females (45-55, 55-65, and more than 65 years age group) were evaluated. MRI was performed on 1.5 Tesla MRI Machine (Siemens Magnetom Avanto) and T1, T2 weighted and STIR images obtained in sagittal, axial, and coronal planes from D8 to L4 levels. Results: There was variation in the appearance of bone marrow among individuals with increasing fat content with age and menopause. It usually followed large globular fat deposition pattern (Pattern 4 described by Ricci et al.) in 60% of post-menopausal group and all cases more than 65 years of age had almost homogenously increased signal intensity of vertebrae probably due to prevalent osteoporosis in post-menopausal Indian females. None of the cases in post-menopausal group had fine punctuated fatty replacement of bone marrow (Pattern 3 described by Ricci et al.). Conclusions: MRI is a very helpful imaging modality in the evaluation of vertebral marrow changes with age and menopause but as the marrow is a tissue undergoing constant change its appearance on MRI is highly variable, and its accurate analysis requires radiological, acumen, expertise and a correct combination of various MRI pulse sequences.

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“…Įtariant kompresinį slankstelio lūžį, esant galimybei, būtų tikslingas ir senesnių radiologinių tyrimų vertinimas. Neaiškiais atvejais, esant klinikinei būtinybei, skiriami kiti radiologiniai tyrimai: magnetinio rezonanso tomografijos tyrimas (MRT) ir kaulų scintigrafijos tyrimas [31,32]. Kaulų čiulpų edemos požymiai MRT tyrime ar radionuklido kaupimas kauluose scintigrafijos metu rodo aktyvų ūmų procesą.…”

Section: Lentelė Stuburo Slankstelių Lūžių Pasiskirstymas Pagal Lokaunclassified

Kompresinių Stuburo Slankstelių Lūžių Klinikiniai Ir Radiologiniai Ypatumai Bei Jų Sąsajos Su Rizikos Veiksniais Moterims Pomenopauziniu Periodu

Talijūnienė¹,

Adomaitienė²,

Dementavičienė³

et al. 2015

Medicinos Teorija Ir Praktika

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Darbo tikslas. Įvertinti kompresinių stuburo slankstelių lūžių dažnį tarp moterų, kurioms nustatyta sumažėjusi kaulų masė pomenopauziniu periodu, bei apibūdinti klinikinius ir radiologinius šių lūžių pasireiškimo ypatumus, įvertinti sąsajas su lūžių rizikos veiksniais. Tiriamieji ir metodai. Atliktas pjūvinis tyrimas, kurio metu menopauzės laikotarpį išgyvenančioms moterims, besikreipiančioms dėl profilaktinio sveikatos patikrinimo ar sveikatos sutrikimų į savo šeimos gydytojus, išmatuotas kaulų mineralų tankis dvisrautės radioabsorbciometrijos (dual-photon energy X-ray absorbtiometry – DXA) metodu. Tiriamosioms, kurioms buvo nustatytas sumažėjęs kaulų mineralų tankis (T lygmuo mažesnis už -1), buvo atliekama stuburo šoninės juosmeninės ir krūtininės dalių rentgenogramos, kurios įvertintos dėl kompresinių stuburo slankstelių deformacijų. Stuburo slankstelių lūžiai vertinti remiantis pusiau kiekybiniu Genanto metodu. Moterims, kurioms nustatytos kompresinės stuburo slankstelių deformacijos, vertinti klinikinės lūžių išraiškos bei rizikos veiksniai. Statistinė analizė atlikta PASW 18.0 programa. Rezultatai. Iš 330 tiriamųjų sumažėjusi kaulų masė nustatyta 206 (62,4 proc.) moterims, iš jų stuburo šoninės juosmeninės ir krūtininės dalių rentgenogramos atliktos 181, vertinimui tinkamos buvo 177 (85,9 proc.). Kompresiniai stuburo slankstelių lūžiai iš vertinimui tinkamų rentgenogramų nustatyti 18,4 proc. (33) tiriamųjų. Visi lūžiai įvertinti kaip seniai įvykę. Vyravo vieno slankstelio (69,7 proc. (23)) ir I° lūžiai (63,6 proc. (21)). Lėtinį nugaros skausmą jautė 24 (72,7 proc.), ūminį patyrė 4 (12,1 proc.) tiriamosios. 12 (36,4 proc.) moterų buvo skausminga palpacija stuburo slankstelių projekcijoje, priestuburinių raumenų skausmingumas ir vietinis tonuso padidėjimas – 9 (27,3 proc.). Didesnė kūno masė ir didesnis kūno masės indeksas bei fizinis aktyvumas statistiškai reikšmingai susiję su didesne kaulų mase. Lėtinis nugaros skausmas, lėtinės širdies ir kraujagyslių ligos, ūgio sumažėjimas, palyginus su buvusiu 30 m., bei didesnis gimdymų skaičius buvo statistiškai reikšmingai susiję su didesniu lūžusių slankstelių skaičiumi. Išvados. Kompresiniai stuburo slankstelių lūžiai nustatyti 33 (18,4 proc.) tiriamosioms iš 177 asmenų vertinimui tinkamų rentgenogramų. Visos nustatytos kompresinės stuburo slankstelių deformacijos įvertintos kaip seniai įvykę lūžiai. Vyravo vieno slankstelio ir I° lūžiai. Didesnis stuburo slankstelių lūžių skaičius reikšmingai statistiškai susijęs su dažniau jaučiamu lėtiniu nugaros skausmu, ūgio sumažėjimu, lėtinėmis širdies ir kraujagyslių ligos, didesniu gimdymų skaičiumi.

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A new diagnostic score to detect osteoporosis in patients undergoing lumbar spine MRI

Abstract: • M-score is a quantitative score potentially screening osteoporosis on lumbar-spine MRI; • This method showed good intra- and inter-reader reproducibility; • M-score may be used for identifying patients who should undergo DXA.

Cited by 90 publications

References 33 publications

Role of lumbar spine signal intensity measurement by MRI in the diagnosis of osteoporosis in post-menopausal women

Role of lumbar spine signal intensity measurement by MRI in the diagnosis of osteoporosis in post-menopausal women

To study the role of various magnetic resonance imaging sequences in assessment of vertebral marrow changes in postmenopausal Indian female population

Kompresinių Stuburo Slankstelių Lūžių Klinikiniai Ir Radiologiniai Ypatumai Bei Jų Sąsajos Su Rizikos Veiksniais Moterims Pomenopauziniu Periodu

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