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Erschienen in: Japanese Journal of Radiology 10/2016

04.08.2016 | Original Article

Diffusion-weighted MRI for detection of hepatic osteodystrophy in primary sclerosing cholangitis: a comparison study with dual-energy X-ray absorptiometry

verfasst von: Sarah Keller, Harald Ittrich, Christoph Schramm, Ansgar W. Lohse, Michael Amling, Gerhard Adam, Jin Yamamura

Erschienen in: Japanese Journal of Radiology | Ausgabe 10/2016

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Abstract

Purpose

Osteodystrophy is a frequent complication in primary sclerosing cholangitis (PSC). The aim was to test the feasibility of vertebral bone diffusion-weighted imaging (DWI) in routine liver MRI for detection of osteoporosis using dual-energy X-ray absorptiometry (DXA) as gold standard.

Materials and methods

Forty PSC patients (50 ± 12.6 years) and ten controls (49.5 ± 13.0 years) were scanned using a DWI spin echo echo-planar sequence (b-factors 0–800 s/mm2) on a 3-T MRI system and DXA (76 kVp). The apparent diffusion coefficient (ADC) and T-score were correlated to laboratory and clinical details using Pearson correlation.

Results

In DXA-diagnosed osteoporosis (n = 3) and osteopenia (n = 12), the mean ADC was decreased (0.26 ± 0.03 and 0.30 ± 0.07 × 10−3 mm2/s) compared to patients with normal DXA scan results (n = 25; 0.32 ± 0.06 × 10−3 mm2/s). No significant correlation of the ADC and T-score (r = 0.24; p = 0.13) was found, but the T-score correlated significantly to disease duration (r = −0.33; p = 0.04). In patients with prednisolone therapy (n = 7), the DXA T-score was significantly lower (−1.46 ± 0.49 vs. −0.16 ± 0.23; p = 0.03).

Conclusion

Diffusion-weighted MRI of the vertebral spine is a feasible technic to detect diffusion alterations caused by osteoporosis but lacks diagnostic capacities for diagnosing minor reductions of the bone mineral density detected by DXA.
Literatur
1.
Zurück zum Zitat Hirschfield GM, Karlsen TH, Lindor KD, Adams DH. Primary sclerosing cholangitis. Lancet. 2013;382:1587–99.CrossRefPubMed Hirschfield GM, Karlsen TH, Lindor KD, Adams DH. Primary sclerosing cholangitis. Lancet. 2013;382:1587–99.CrossRefPubMed
2.
Zurück zum Zitat Goel V, Kar P. Hepatic osteodystrophy. Trop Gastroenterol. 2010;31:82–6.PubMed Goel V, Kar P. Hepatic osteodystrophy. Trop Gastroenterol. 2010;31:82–6.PubMed
3.
Zurück zum Zitat Guanabens N, Cerda D, Monegal A, et al. Low bone mass and severity of cholestasis affect fracture risk in patients with primary biliary cirrhosis. Gastroenterology. 2010;138:2348–56.CrossRefPubMed Guanabens N, Cerda D, Monegal A, et al. Low bone mass and severity of cholestasis affect fracture risk in patients with primary biliary cirrhosis. Gastroenterology. 2010;138:2348–56.CrossRefPubMed
4.
Zurück zum Zitat Menon KV, Angulo P, Weston S, Dickson ER, Lindor KD. Bone disease in primary biliary cirrhosis: independent indicators and rate of progression. J Hepatol. 2001;35:316–23.CrossRefPubMed Menon KV, Angulo P, Weston S, Dickson ER, Lindor KD. Bone disease in primary biliary cirrhosis: independent indicators and rate of progression. J Hepatol. 2001;35:316–23.CrossRefPubMed
5.
Zurück zum Zitat Guichelaar MM, Kendall R, Malinchoc M, Hay JE. Bone mineral density before and after OLT: long-term follow-up and predictive factors. Liver Transpl. 2006;12:1390–402.CrossRefPubMed Guichelaar MM, Kendall R, Malinchoc M, Hay JE. Bone mineral density before and after OLT: long-term follow-up and predictive factors. Liver Transpl. 2006;12:1390–402.CrossRefPubMed
6.
Zurück zum Zitat Angulo P, Grandison GA, Fong DG, et al. Bone disease in patients with primary sclerosing cholangitis. Gastroenterology. 2011;140:180–8.CrossRefPubMed Angulo P, Grandison GA, Fong DG, et al. Bone disease in patients with primary sclerosing cholangitis. Gastroenterology. 2011;140:180–8.CrossRefPubMed
7.
Zurück zum Zitat Raszeja-Wyszomirska J, Kucharski R, Zygmunt M, Safranow K, Miazgowski T. The impact of fragility fractures on health-related quality of life in patients with primary sclerosing cholangitis. Hepat Mon. 2015;15:e25539.CrossRefPubMedPubMedCentral Raszeja-Wyszomirska J, Kucharski R, Zygmunt M, Safranow K, Miazgowski T. The impact of fragility fractures on health-related quality of life in patients with primary sclerosing cholangitis. Hepat Mon. 2015;15:e25539.CrossRefPubMedPubMedCentral
8.
Zurück zum Zitat Berdal JE, Ebbesen J. Rydning A (incidence and prevalence of autoimmune liver diseases). Tidsskr Nor Laegeforen. 1998;118:4517–9.PubMed Berdal JE, Ebbesen J. Rydning A (incidence and prevalence of autoimmune liver diseases). Tidsskr Nor Laegeforen. 1998;118:4517–9.PubMed
9.
Zurück zum Zitat Bambha K, Kim WR, Talwalkar J, et al. Incidence, clinical spectrum, and outcomes of primary sclerosing cholangitis in a United States community. Gastroenterology. 2003;125:1364–9.CrossRefPubMed Bambha K, Kim WR, Talwalkar J, et al. Incidence, clinical spectrum, and outcomes of primary sclerosing cholangitis in a United States community. Gastroenterology. 2003;125:1364–9.CrossRefPubMed
10.
Zurück zum Zitat Lindkvist B, Benito de Valle M, Gullberg B, Bjornsson E. Incidence and prevalence of primary sclerosing cholangitis in a defined adult population in Sweden. Hepatology. 2010;52:571–7.CrossRefPubMed Lindkvist B, Benito de Valle M, Gullberg B, Bjornsson E. Incidence and prevalence of primary sclerosing cholangitis in a defined adult population in Sweden. Hepatology. 2010;52:571–7.CrossRefPubMed
11.
Zurück zum Zitat Dietrich O, Biffar A, Reiser MF, Baur-Melnyk A. Diffusion-weighted imaging of bone marrow. Semin Musculoskelet Radiol. 2009;13:134–44.CrossRefPubMed Dietrich O, Biffar A, Reiser MF, Baur-Melnyk A. Diffusion-weighted imaging of bone marrow. Semin Musculoskelet Radiol. 2009;13:134–44.CrossRefPubMed
12.
Zurück zum Zitat Griffith JF, Yeung DK, Antonio GE, et al. Vertebral marrow fat content and diffusion and perfusion indexes in women with varying bone density: MR evaluation. Radiology. 2006;241:831–8.CrossRefPubMed Griffith JF, Yeung DK, Antonio GE, et al. Vertebral marrow fat content and diffusion and perfusion indexes in women with varying bone density: MR evaluation. Radiology. 2006;241:831–8.CrossRefPubMed
13.
Zurück zum Zitat Herrmann J, Krstin N, Schoennagel BP, et al. Age-related distribution of vertebral bone-marrow diffusivity. Eur J Radiol. 2012;81:4046–9.CrossRefPubMed Herrmann J, Krstin N, Schoennagel BP, et al. Age-related distribution of vertebral bone-marrow diffusivity. Eur J Radiol. 2012;81:4046–9.CrossRefPubMed
14.
Zurück zum Zitat Yeung DK, Wong SY, Griffith JF, Lau EM. Bone marrow diffusion in osteoporosis: evaluation with quantitative MR diffusion imaging. J Magn Reson Imaging. 2004;19:222–8.CrossRefPubMed Yeung DK, Wong SY, Griffith JF, Lau EM. Bone marrow diffusion in osteoporosis: evaluation with quantitative MR diffusion imaging. J Magn Reson Imaging. 2004;19:222–8.CrossRefPubMed
15.
Zurück zum Zitat Zhang CY, Rong R, Wang XY. Age-related changes of bone marrow of normal adult man on diffusion weighted imaging. Chin Med Sci J. 2008;23:162–5.CrossRefPubMed Zhang CY, Rong R, Wang XY. Age-related changes of bone marrow of normal adult man on diffusion weighted imaging. Chin Med Sci J. 2008;23:162–5.CrossRefPubMed
16.
Zurück zum Zitat Baur A, Stabler A, Bruning R, et al. Diffusion-weighted MR imaging of bone marrow: differentiation of benign versus pathologic compression fractures. Radiology. 1998;207:349–56.CrossRefPubMed Baur A, Stabler A, Bruning R, et al. Diffusion-weighted MR imaging of bone marrow: differentiation of benign versus pathologic compression fractures. Radiology. 1998;207:349–56.CrossRefPubMed
17.
Zurück zum Zitat Griffith JF, Yeung DK, Tsang PH, et al. Compromised bone marrow perfusion in osteoporosis. J Bone Miner Res. 2008;23:1068–75.CrossRefPubMed Griffith JF, Yeung DK, Tsang PH, et al. Compromised bone marrow perfusion in osteoporosis. J Bone Miner Res. 2008;23:1068–75.CrossRefPubMed
18.
Zurück zum Zitat Le Bihan D. From Brownian motion to mind imaging: diffusion MRI. Bull Acad Natl Med. 2006;190:1605–27 (discussion 1627).PubMed Le Bihan D. From Brownian motion to mind imaging: diffusion MRI. Bull Acad Natl Med. 2006;190:1605–27 (discussion 1627).PubMed
19.
Zurück zum Zitat World Health Organization. Assessment of fracture risk and its application to screening for postmenopausal osteoporosis. Report of a WHO Study Group. World Health Organ Tech Rep Ser. 1994;843:1–129. World Health Organization. Assessment of fracture risk and its application to screening for postmenopausal osteoporosis. Report of a WHO Study Group. World Health Organ Tech Rep Ser. 1994;843:1–129.
20.
Zurück zum Zitat Angulo P, Therneau TM, Jorgensen A, et al. Bone disease in patients with primary sclerosing cholangitis: prevalence, severity and prediction of progression. J Hepatol. 1998;29:729–35.CrossRefPubMed Angulo P, Therneau TM, Jorgensen A, et al. Bone disease in patients with primary sclerosing cholangitis: prevalence, severity and prediction of progression. J Hepatol. 1998;29:729–35.CrossRefPubMed
21.
Zurück zum Zitat Campbell MS, Lichtenstein GR, Rhim AD, Pazianas M, Faust T. Severity of liver disease does not predict osteopenia or low bone mineral density in primary sclerosing cholangitis. Liver Int. 2005;25:311–6.CrossRefPubMed Campbell MS, Lichtenstein GR, Rhim AD, Pazianas M, Faust T. Severity of liver disease does not predict osteopenia or low bone mineral density in primary sclerosing cholangitis. Liver Int. 2005;25:311–6.CrossRefPubMed
22.
Zurück zum Zitat Hay JE, Lindor KD, Wiesner RH, Dickson ER, Krom RA, LaRusso NF. The metabolic bone disease of primary sclerosing cholangitis. Hepatology. 1991;14:257–61.CrossRefPubMed Hay JE, Lindor KD, Wiesner RH, Dickson ER, Krom RA, LaRusso NF. The metabolic bone disease of primary sclerosing cholangitis. Hepatology. 1991;14:257–61.CrossRefPubMed
23.
Zurück zum Zitat Dietrich O, Geith T, Reiser MF, Baur-Melnyk A. Diffusion imaging of the vertebral bone marrow. NMR Biomed 2015. Dietrich O, Geith T, Reiser MF, Baur-Melnyk A. Diffusion imaging of the vertebral bone marrow. NMR Biomed 2015.
24.
Zurück zum Zitat Hatipoglu HG, Selvi A, Ciliz D, Yuksel E. Quantitative and diffusion MR imaging as a new method to assess osteoporosis. AJNR Am J Neuroradiol. 2007;28:1934–7.CrossRefPubMed Hatipoglu HG, Selvi A, Ciliz D, Yuksel E. Quantitative and diffusion MR imaging as a new method to assess osteoporosis. AJNR Am J Neuroradiol. 2007;28:1934–7.CrossRefPubMed
26.
Zurück zum Zitat Schellinger D, Lin CS, Fertikh D, et al. Normal lumbar vertebrae: anatomic, age, and sex variance in subjects at proton MR spectroscopy—initial experience. Radiology. 2000;215:910–6.CrossRefPubMed Schellinger D, Lin CS, Fertikh D, et al. Normal lumbar vertebrae: anatomic, age, and sex variance in subjects at proton MR spectroscopy—initial experience. Radiology. 2000;215:910–6.CrossRefPubMed
27.
Zurück zum Zitat Schellinger D, Lin CS, Hatipoglu HG, Fertikh D. Potential value of vertebral proton MR spectroscopy in determining bone weakness. AJNR Am J Neuroradiol. 2001;22:1620–7.PubMed Schellinger D, Lin CS, Hatipoglu HG, Fertikh D. Potential value of vertebral proton MR spectroscopy in determining bone weakness. AJNR Am J Neuroradiol. 2001;22:1620–7.PubMed
28.
Zurück zum Zitat Tang GY, Lv ZW, Tang RB, et al. Evaluation of MR spectroscopy and diffusion-weighted MRI in detecting bone marrow changes in postmenopausal women with osteoporosis. Clin Radiol. 2010;65:377–81.CrossRefPubMed Tang GY, Lv ZW, Tang RB, et al. Evaluation of MR spectroscopy and diffusion-weighted MRI in detecting bone marrow changes in postmenopausal women with osteoporosis. Clin Radiol. 2010;65:377–81.CrossRefPubMed
Metadaten
Titel
Diffusion-weighted MRI for detection of hepatic osteodystrophy in primary sclerosing cholangitis: a comparison study with dual-energy X-ray absorptiometry
verfasst von
Sarah Keller
Harald Ittrich
Christoph Schramm
Ansgar W. Lohse
Michael Amling
Gerhard Adam
Jin Yamamura
Publikationsdatum
04.08.2016
Verlag
Springer Japan
Erschienen in
Japanese Journal of Radiology / Ausgabe 10/2016
Print ISSN: 1867-1071
Elektronische ISSN: 1867-108X
DOI
https://doi.org/10.1007/s11604-016-0573-z

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