Application of DIXON MRI sequencing in the diagnosis of changes in the spongy substance of vertebral bodies in comparison with osteodensitometry data

The aim of this study was to analyze the patterns of changes in the fat fraction of the vertebral bodies according to the modified DIXON protocol (mDixon, MRI) in patients of different age groups with densitometry data.

Materials and methods. In the course of our study, a Siemens Magnetom Verio 3T tomograph was used for diagnostics, for assessing the condition of the vertebrae of the lumbosacral spine, measuring FF, a computer program was used: “RadiAnt DICOM viewer”. DIXON (two-point) parameters of TSE pulse train with T2 type of weighting: TR 4000 ms, TE 88 ms, slice thickness 4 mm, matrix 320 × 320, NEX 1, FOV 260 × 260 mm, pixel size 0.8 × 0.8 mm, bandwidth 345 Hz/pixel. Scanning time: 3 min. 50 sec. We also used a GE Lunar Prodigy densitometer. Measurement parameters: mode – standard (13–25 cm), length 19.1 cm, width 18.0 cm. Method: mDixon.

Results. 71 patients were examined (average age is 57 years; average BMI (body mass index): 27.94). Osteopenia was diagnosed in 21 patients, osteoporosis – in 13. Bone mineral density (BMD) was obtained using X-ray densitometry, which served as a reference for detecting abnormal bone density and osteoporosis. A comparison was made of BMD values in patients with normal and patients with osteoporosis / osteopenia: the values in patients with normal were 21.85% higher than in patients with osteoporosis / osteopenia. We also compared the parameters of vertebral fat density (FF) in patients with normal and pathology – the values in patients with normal were 15.65% less than in patients with pathology. Correlation analysis revealed a relationship between BMD and FF parameters. According to the results of the morphometry of the vertebral bodies, wedge-shaped deformity of the vertebral bodies was revealed in 8% of patients with osteoporosis / osteopenia.

Conclusions. The MRI method based on the DIXON trace is of great importance in the diagnosis of changes in the spongy substance of the vertebral bodies. In the study of correlation analysis, an inverse relationship was found between the BMD and FF parameters.

1. Savchenko T.N., Agaeva M.I., Nosova L.A., Shapovalova Yu.O. Prevention of osteoporosis in women. Breast cancer. Mother and Child. 2017; 25 (12): 879–883. (In Russian)

2. Mikhailov E.E., Benevolenskaya L.I. Osteoporosis Guide / Ed. L.I. Benevolenskaya. Moscow: BINOM, Knowledge Laboratory, 2003. (In Russian)

3. National Osteoporosis Foundation. Osteoporosis clinical practice guideline. National osteoporosis Foundation website. Available at: http://www.nof.org (дата обращения 20.05.2021).

4. Kanhaiya A., Yatish A., Rajesh K.C. et al. Evaluation of MR Spectroscopy and Diffusion-Weighted MRI in Post-menopausal Bone Strength. Eur. Cureus. 2015; 7: e327. https://dx.doi.org/10.7759%2Fcureus.327

5. Griffith J.F., Yeung D.K., Antonio G.E. et al. Vertebral marrow fat content and diffusion and perfusion indexes in women with varying bone density: MR evaluation. Radiology. 2006; 241: 831–838. https://doi.org/10.1148/radiol.2413051858

6. Ghannam N.N. WHO Study Group. Assessment of fracture risk and its application to screening for postmenopausal osteoporosis. Report of a WHO Study Group. World Health Organ Tech Rep Ser. Geneva: WHO. 1994; 14 (843): 1–129. https://doi.org/10.5144/0256-4947.1994.527

7. Losch M.S., Swamy A., Elmi-Terander A. et al. Proton density fat fraction of the spinal column: an MRI cadaver study. BioMedical Engineering OnLine. 2021; 7. https://doi.org/10.1186/s12938-020-00846-4

8. Glocker B., Konukoglu E., Lavdas I. et al. Correction of Fat-Water Swaps in Dixon MRI. MICCAI. 2016. Vol 9902. Lecture Notes in Computer Science. Springer, Cham. https://doi.org/10.1007/978-3-319-46726-9_62

9. Low R.N., Austin M.J., Ma J. Fast spin-echo triple echo dixon: Initial clinical experience with a novel pulse sequence for simultaneous fat-suppressed and nonfatsuppressed T2-weighted spine magnetic resonance imaging. J. Magn. Reson. Imaging. 2011; 33: 390–400. https://doi.org/10.1002/jmri.22453

10. Brandão S., Seixas D., Ayres-Basto M. et al. Comparing T1-weighted and T2-weighted three-point Dixon technique with conventional T1-weighted fat-saturation and short-tau inversion recovery (STIR) techniques for the study of the lumbar spine in a short-bore MRI machine. Clin. Radiol. 2013; 68: e617–623. https://doi.org/10.1016/j.crad.2013.06.004

11. Ma J., Singh S.K., Kumar A.J. et al. T2-weighted spine imaging with a fast three-point dixon technique: comparison with chemical shift selective fat suppression. J. Magn. Reson. Imaging. 2004; 20: 1025–1029. https://doi.org/10.1002/jmri.20201

12. Yeung H.N., Kormos D.W. Separation of true fat and water images by correcting magnetic field inhomogeneity in situ. Radiology. 1986; 159: 783–786. https://doi.org/10.1148/radiology.159.3.3704157

13. Sangmin L., Dae Seob Ch., Hwa S.Sh. et al. FSE T2-weighted two-point Dixon technique for fat suppression in the lumbar spine: comparison with SPAIR technique. Diagn. Interv. Radiol. 2018; 24: 175–180. https://dx.doi.org/10.5152%2Fdir.2018.17320

14. Calculation of the fat fraction by quantitative MRI methods. Available at: https://www.philips.ru/healthcare/education-resources/research-projects/fat-fraction-calculation (accessed May 5, 2021). (In Russian)

15. Youn I., Lee H.Y., Kim J.K. Correlation between vertebral marrow fat fraction measured using dixon quantitative chemical shift MRI and BMD value on dual-energy X-ray absorptiometry. J. Korean Soc. Magn. Reson. Med. 2012; 16: 16–24. https://doi.org/10.13104/jksmrm.2012.16.1.16

16. Chang R., Ma X., Jiang Y. et al. Percentage fat fraction in magnetic resonance imaging: upgrading the osteoporosis-detecting parameter. BMC Med. Imaging. 2020; 20: 30. https://doi.org/10.1186/s12880-020-00423-0

17. Menshchikov P.E., Ivantsova A.S., Akhadov T.A. et al. 1H MRS as a novel quantitative method for osteoporosis detection. J. Phys.: Conf. Series. 2020, 1461, 012098. https://doi.org/10.1088/1742-6596/1461/1/012098

18. He J., Fang H., Li X. Vertebral bone marrow fat content in normal adults with varying bone densities at 3T magnetic resonance imaging. Acta Radiol. 2018; 60 (4): 509–515. https://doi.org/10.1177/0284185118786073