3 Tesla MRI detects deterioration in proximal femur microarchitecture and strength in long-term glucocorticoid users compared with controls.
3 Tesla MRI detects deterioration in proximal femur microarchitecture and strength in long-term glucocorticoid users compared with controls.
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DOI：
10.1002/jmri.24927
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发表时间：
2015-12
期刊：
影响因子：
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通讯作者：
Honig S
中科院分区：
文献类型：
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作者：
Chang G;Rajapakse CS;Regatte RR;Babb J;Saxena A;Belmont HM;Honig S
糖皮质激素诱导的骨质疏松症（GIO）是最常见的继发性骨质疏松症，与不使用糖皮质激素的人相比，使用糖皮质激素的人骨折的风险增加。骨矿物质密度（BMD）与GIO骨折风险之间没有明确的关系。我们使用3特斯拉(T) MRI来研究GIO受试者股骨近端微结构的改变。这项研究得到了机构审查委员会的批准。我们招募了6名长期（> - 1年）使用糖皮质激素的受试者（中位年龄= 52.5（39.2-58.7）岁）和6名对照组（中位年龄= 65.5[62-75.5]岁）。对于非优势髋关节，所有受试者均接受双能x线吸收仪（DXA）评估骨密度，3T磁共振成像（MRI, 3D FLASH）评估骨微结构和强度指标。与对照组相比，糖皮质激素使用者表现出较低的股骨颈小梁数（- 50.3%,1.12 [0.84-1.54]mm−1比2.27 [1.88-2.73]mm−1,P = 0.02），钢板-棒比（- 20.1%,1.48[1.39-1.71]比1.86 [1.76-2.20],P = 0.03），弹性模量（- 64.8%比- 74.8%,1.54 [1.22-3.19]GPa比2.31 [1.87-4.44]GPa比6.15 [5.00-7.09]GPa比6.59 [5.58-7.31]GPa比6.15 [5.00-7.09]GPa比6.59 [5.58-7.31]GPa, P < 0.05），较高的股骨颈小梁分离(+192%，0.705 [0.462-1.00] mm vs . 0.241 [0.194-0.327] mm, P = 0.02。组间股骨颈小梁厚度（- 2.7%,0.193 [0.184-0.217]mm vs . 0.199 [0.179-0.210] mm, P = 0.94）或股骨颈BMD t评分（+20.7%,- 2.1 [- 2.8 - - 1.4]vs . - 2.6 [- 3.3 - - 2.5], P = 0.24）均无差异。3T MRI可以潜在地检测到长期糖皮质激素使用者股骨近端微结构和强度的有害变化。
Glucocorticoid-induced osteoporosis (GIO) is the most common secondary form of osteoporosis, and glucocorticoid users are at increased risk for fracture compared with nonusers. There is no established relationship between bone mineral density (BMD) and fracture risk in GIO. We used 3 Tesla (T) MRI to investigate how proximal femur microarchitecture is altered in subjects with GIO. This study had institutional review board approval. We recruited 6 subjects with long-term (> 1 year) glucocorticoid use (median age = 52.5 (39.2–58.7) years) and 6 controls (median age = 65.5 [62–75.5] years). For the nondominant hip, all subjects underwent dual-energy x-ray absorptiometry (DXA) to assess BMD and 3T magnetic resonance imaging (MRI, 3D FLASH) to assess metrics of bone microarchitecture and strength. Compared with controls, glucocorticoid users demonstrated lower femoral neck trabecular number (−50.3%, 1.12 [0.84–1.54] mm−1 versus 2.27 [1.88–2.73] mm−1, P = 0.02), plate-to-rod ratio (−20.1%, 1.48 [1.39–1.71] versus 1.86 [1.76–2.20], P = 0.03), and elastic modulus (−64.8% to −74.8%, 1.54 [1.22–3.19] GPa to 2.31 [1.87–4.44] GPa versus 6.15 [5.00–7.09] GPa to 6.59 [5.58–7.31] GPa, P < 0.05), and higher femoral neck trabecular separation (+192%, 0.705 [0.462–1.00] mm versus 0.241 [0.194–0.327] mm, P = 0.02). There were no differences in femoral neck trabecular thickness (−2.7%, 0.193 [0.184–0.217] mm versus 0.199 [0.179–0.210] mm, P = 0.94) or femoral neck BMD T-scores (+20.7%, −2.1 [−2.8 to −1.4] versus −2.6 [−3.3 to −2.5], P = 0.24) between groups. The 3T MRI can potentially detect detrimental changes in proximal femur microarchitecture and strength in long-term glucocorticoid users.