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Inhomogeneous osteoporotic changes of vertebrae with hormone replacement therapy

Year 2015, Volume: 5 Issue: 2, 71 - 76, 07.09.2015
https://doi.org/10.5505/sakaryamj.2015.63644

Abstract

Background and Aim: To evaluate postmenopausal physiological bone marrow changes with hormone replacement therapy(HRT) of the lumbar spine using magnetic resonance (MR) imaging. Materials and Methods: BMD measurement and lumbar spine MR imaging performed in 110 postmenopausal women (PW). Women were classified as normal, osteopathic and osteoporotic. These patients grouped according to women who were and women who were not receiving HRT. Mean intensity from the center of each lumbar vertebrae at the mid-sagital plane in a region of interest (ROI), measured and calculated from MR image data. Correlation between T1 and T2 intensities with age and BMD evaluated using Pearson's correlation coefficient. Results: No significant positive correlation found between BMD and T1, T2 intensity among all PW and PW who were not using HRT. However there was a correlation between T1,T2 intensities and BMD in PW receiving HRT. BMD was inversely correlated with age. No significant correlation found between the T1, T2 intensities of bone marrow at the center of the vertebrae and BMD.Conclusion: The center of the lumbar vertebrae is probably less and lately affected from fatty transformation by the help of HRT. This study may Show that postmenopausal hormone theraphy may protect vertebrae from compression fractures.

References

  • Link TM. Osteoporosis imaging: state of the art and advanced imaging. Radiology 2012;263:3-17.
  • Kijowski R, Tuite M, Kruger D, Munoz Del Rio A, Kleerekoper M, Binkley N. Evaluation of trabecular microarchitecture in nonosteoporotic postmenopausal women with and without fracture. J Bone Miner Res 2012;27:1494-500.
  • Shen W, Scherzer R, Gantz M, Chen J, Punyanitya M, Lewis CE et al. Relationship between MRI-measured bone marrow adipose tissue and hip and spine bone mineral density in African-American and Caucasian participants: the CARDIA study. J Clin Endocrinol Metab 2012;97:1337-46.
  • Chen YJ, Chen HY, Hsu HC. Sequential magnetic resonance imaging changes in osteoporotic compression fractures: can it be used as a risk predictor for nonunion? Spine 2011;15;36:2363.
  • Régis-Arnaud A, Guiu B, Walker PM, Krausé D, Ricolfi F, Ben Salem D. Bone marrow fat quantification of osteoporotic vertebral compression fractures: comparison of multi-voxel proton MR spectroscopy and chemical-shift gradient-echo MR imaging. Acta Radiol 2011;52:1032-6.
  • Guglielmi G, Muscarella S, Bazzocchi A. Integrated imaging approach osteoporosis: state-of-the-art review and update. Radiographics 2011;31:1343-64.
  • Abdel-Wanis ME, Solyman MT, Hasan NM. Sensitivity, specificity and accuracy of magnetic resonance imaging for differentiating vertebral compression fractures caused by malignancy, osteoporosis, and infections. J Orthop Surg 2011;19:145-50.
  • Kazawa N. T2WI MRI and MRI-MDCT correlations of the osteoporotic vertebral compressive fractures. Eur J Radiol 2012;81:1630-6.
  • Biffar A, Schmidt GP, Sourbron S, D'Anastasi M, Dietrich O, Notohamiprodjo M et al. Quantitative analysis of vertebral bone marrow perfusion using dynamic contrast-enhanced MRI: initial results in osteoporotic patients with acute vertebral fracture. J Magn Reson Imaging 2011;33:676-83.
  • Li X, Kuo D, Schafer AL, Porzig A, Link TM, Black D et al. Quantification of vertebral bone marrow fat content using 3 Tesla MR spectroscopy: reproducibility, vertebral variation, and applications in osteoporosis. J Magn Reson Imaging 2011;33:974-79.
  • Wang YX, Kwok AW, Griffith JF, Leung JC, Ma HT, Ahuja AT et al. Relationship between hip bone mineral density and lumbar disc degeneration: a study in elderly subjects using an eight-level MRI-based disc degeneration grading system. J Magn Reson Imaging 2011;33:916-20.
  • Sheu Y, Cauley JA. The role of bone marrow and visceral fat on bone metabolism. Curr Osteoporos Rep 2011;9:67-75.
  • Griffith JF, Genant HK. New imaging modalities in bone. Curr Rheumatol Rep 2011;13:241-50.
  • Reeve J, Arlot M, Wootton R, Edouard C, Tellez M, Hesp R, et al. Skeletal blood flow, iliac histomorphometry, and strontium kinetics in osteoporosis: a relationship between blood flow and corrected apposition rate. J Clin Endocrinol Metab 1988;66:1124-31.
  • Burkhardt R, Bartl R, Frisch B. The structural relationship of bone forming and endothelial cells of the bone marrow. In: Arlet J, Ficat RP, Hungerford DS, eds. Bone circulation. Baltimore, Md: Williams & Wilkins, 1984;2-14.
  • Samuels A, Perry MJ, Gibson RL, Colley S, Tobias JH. Role of endothelial nitric oxide synthase in estrogen-induced osteogenesis. Bone 2001;29:24–29.

Hormon replasman tedavisi ile vertebralarda homojen olmayan osteoporotik değişiklikler

Year 2015, Volume: 5 Issue: 2, 71 - 76, 07.09.2015
https://doi.org/10.5505/sakaryamj.2015.63644

Abstract

Amaç: Manyetik rezonans (MR) görüntüleme kullanarak menapoz sonrası hormon tedavisi ile bel omurgasında oluşan fizyolojik değişiklikleri incelemekGereç ve Yöntem: Menopoz sonrası 110 kadın hastaya kemik mineral yoğunluğu (KMY) ölçümü ve standart lomber MRG tetkiki yapıldı. Hastalar KMY ölçümüne göre normal, osteopeni ve osteoporoz olarak guruplara ayırıldı. Ayrıca bu hastalar hormon tedavisi alan ve hormon tedavisi almayan olarak da iki gruba ayırıldı. Lomber MR tetkikinde orta sagital düzlemde T1 ve T2 ağırlıklı sekanslardan her lomber vertebranın merkezine ilgili alan birimi (ROI) yerleştirilerek sinyal değerleri ölçüldü ve ortalamaları hesaplandı. Lomber MR verilerinden elde edilen ortalama sinyal değerleri ile yaş ve KMY değerleri Pearson korelasyon katsayısı kullanılarak incelendi.Bulgular: Tüm menapoz sonrası ve hormon tedavisi almayan olgularda lomber vertebra MR sinyal değerleri ile KMY değerleri arasında korelasyon bulunmamıştır. Ancak hormon tedavisi alan menapoz sonrası kadınlarda minimal korelasyon saptanmıştır. KMY değerleri ile yaş arasında negatif korelasyon varken T1 ve T2 ağırlıklı sinyal değerlerinin yaş ile ilişkili olmadığı bulunmuştur.Sonuç: Bel omurlarının merkezinin daha fazla vasküler yapı içermesi nedeniyle HRT alanların osteoporozdan daha geç ve az etkilendiği düşünülmüştür. Bu çalışma, hormon tedavisinin menapoz sonrasında kompresyon kırıklarından koruyabileceğini gösterebilir.

References

  • Link TM. Osteoporosis imaging: state of the art and advanced imaging. Radiology 2012;263:3-17.
  • Kijowski R, Tuite M, Kruger D, Munoz Del Rio A, Kleerekoper M, Binkley N. Evaluation of trabecular microarchitecture in nonosteoporotic postmenopausal women with and without fracture. J Bone Miner Res 2012;27:1494-500.
  • Shen W, Scherzer R, Gantz M, Chen J, Punyanitya M, Lewis CE et al. Relationship between MRI-measured bone marrow adipose tissue and hip and spine bone mineral density in African-American and Caucasian participants: the CARDIA study. J Clin Endocrinol Metab 2012;97:1337-46.
  • Chen YJ, Chen HY, Hsu HC. Sequential magnetic resonance imaging changes in osteoporotic compression fractures: can it be used as a risk predictor for nonunion? Spine 2011;15;36:2363.
  • Régis-Arnaud A, Guiu B, Walker PM, Krausé D, Ricolfi F, Ben Salem D. Bone marrow fat quantification of osteoporotic vertebral compression fractures: comparison of multi-voxel proton MR spectroscopy and chemical-shift gradient-echo MR imaging. Acta Radiol 2011;52:1032-6.
  • Guglielmi G, Muscarella S, Bazzocchi A. Integrated imaging approach osteoporosis: state-of-the-art review and update. Radiographics 2011;31:1343-64.
  • Abdel-Wanis ME, Solyman MT, Hasan NM. Sensitivity, specificity and accuracy of magnetic resonance imaging for differentiating vertebral compression fractures caused by malignancy, osteoporosis, and infections. J Orthop Surg 2011;19:145-50.
  • Kazawa N. T2WI MRI and MRI-MDCT correlations of the osteoporotic vertebral compressive fractures. Eur J Radiol 2012;81:1630-6.
  • Biffar A, Schmidt GP, Sourbron S, D'Anastasi M, Dietrich O, Notohamiprodjo M et al. Quantitative analysis of vertebral bone marrow perfusion using dynamic contrast-enhanced MRI: initial results in osteoporotic patients with acute vertebral fracture. J Magn Reson Imaging 2011;33:676-83.
  • Li X, Kuo D, Schafer AL, Porzig A, Link TM, Black D et al. Quantification of vertebral bone marrow fat content using 3 Tesla MR spectroscopy: reproducibility, vertebral variation, and applications in osteoporosis. J Magn Reson Imaging 2011;33:974-79.
  • Wang YX, Kwok AW, Griffith JF, Leung JC, Ma HT, Ahuja AT et al. Relationship between hip bone mineral density and lumbar disc degeneration: a study in elderly subjects using an eight-level MRI-based disc degeneration grading system. J Magn Reson Imaging 2011;33:916-20.
  • Sheu Y, Cauley JA. The role of bone marrow and visceral fat on bone metabolism. Curr Osteoporos Rep 2011;9:67-75.
  • Griffith JF, Genant HK. New imaging modalities in bone. Curr Rheumatol Rep 2011;13:241-50.
  • Reeve J, Arlot M, Wootton R, Edouard C, Tellez M, Hesp R, et al. Skeletal blood flow, iliac histomorphometry, and strontium kinetics in osteoporosis: a relationship between blood flow and corrected apposition rate. J Clin Endocrinol Metab 1988;66:1124-31.
  • Burkhardt R, Bartl R, Frisch B. The structural relationship of bone forming and endothelial cells of the bone marrow. In: Arlet J, Ficat RP, Hungerford DS, eds. Bone circulation. Baltimore, Md: Williams & Wilkins, 1984;2-14.
  • Samuels A, Perry MJ, Gibson RL, Colley S, Tobias JH. Role of endothelial nitric oxide synthase in estrogen-induced osteogenesis. Bone 2001;29:24–29.
There are 16 citations in total.

Details

Primary Language Turkish
Journal Section Articles
Authors

Aykut Recep Aktaş This is me

İlker Günyeli This is me

Tuna Parpar This is me

Ömer Yılmaz This is me

Mustafa Kayan This is me

Mert Köroğlu This is me

Bumin Değirmenci This is me

Meltem Çetin This is me

Nisa Ünlü This is me

Ayşe Kumul This is me

Hakan Demirtaş This is me

Mustafa Kara This is me

Publication Date September 7, 2015
Submission Date September 7, 2015
Published in Issue Year 2015 Volume: 5 Issue: 2

Cite

AMA Aktaş AR, Günyeli İ, Parpar T, Yılmaz Ö, Kayan M, Köroğlu M, Değirmenci B, Çetin M, Ünlü N, Kumul A, Demirtaş H, Kara M. Hormon replasman tedavisi ile vertebralarda homojen olmayan osteoporotik değişiklikler. Sakarya Tıp Dergisi. June 2015;5(2):71-76. doi:10.5505/sakaryamj.2015.63644

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