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Potential Value of Vertebral Proton MR Spectroscopy in Determining Bone Weakness

Dieter Schellingera, Chin Shoou Lina, Hatice Gul Hatipoglua and Djamil Fertikha

a From the Department of Radiology, Georgetown University Medical Center, Washington, DC.



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  		FIG 1. Relationship of age, sex, and percent fat fraction (%FF). Patients are grouped by decades of age; within each decade group, male and female subjects are separately represented. There is a linear increase of %FF with age and a difference in this variable between male and female subjects.FIG 2. %FF for both normal and abnormal bone, by decades of age. Abnormal bone has a higher %FF in all age groups



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  		FIG 3. Comparison of patients with and a patient without Schmorl's nodes, the most common pathologic finding.

A, Schmorl's nodes at the lower thoracic and lumbar levels in a 38-year-old man. The 1H MRS shows a water peak (left) and a lipid peak (right). The LWR is 1.1, which yields a %FF of 52. This is relatively high for this age group (see fig 2).

B, Schmorl's nodes at the inferior endplates of L2 and L3 in a 60-year-old man. The 1H MRS shows the lipid peak (right) to be much higher than the water peak (left). The LWR measured 1.76, which yields a %FF of 64. This is relatively high for this age group (see fig 2).

C, Normal bone in a 17-year-old girl. The LWR measured 0.19, which yields a %FF of 16.



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  		FIG 4. Examples of compression fractures.

A, An 87-year-old man with recent compression fracture of L3 and Schmorl's node at the superior endplate of L2. The 1H MRS at L2 revealed a LWR of 2.3, for a %FF of 70, which is relatively high for this age group.

B, An 80-year-old woman with recent compression fracture of L1, probable fracture at the inferior L3 vertebral body, and inferior endplate depression at L4 and L5. The 1H MRS at L2 shows a very prominent lipid peak. The LWR measured 2.4, for a %FF of 71, which is relatively high for this age group.





Copyright © 2008 by the American Society of Neuroradiology. Print ISSN: 0195-6108 Online ISSN: 1936-959X