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I
ð
CH
¼
CH
Þ
unsaturation level
¼
I
ð
CH
¼
CH
Þ
þ
I
ð
CH
2
CH
¼
CH
CH
2
Þ
þ
I
ðð
CH
2
Þ
n
Þ
where I
(
-
CH=CH
-
)
,I
(
-
CH2
-
CH=CH
-
CH2
-
)
, and I
(
-
(CH2)n
-
)
are the signal amplitudes of
the ole
nic (
CH=CH
) peak at 5.3 ppm, the
ʱ
-ole
nic (
CH
2
-
CH=CH
CH
2
-
)
-
-
-
-
peak at 2.00 ppm, and the methylene (
) peak at 1.30 ppm, respectively.
Patsch et al. obtained
1
H-MRS-based unsaturation levels of L1
-
(CH
2
)
n
-
-
L3 in 69 post-
menopausal women [
113
]. Thirty
six subjects (47.8 %) had spinal and/or peripheral
osteoporotic fractures. After adjustment for age, race, and QCT-based lumbar
BMD,
‐
the authors observed that
the prevalence of osteoporotic fractures was
associated with
1.7 % lower unsaturation levels. Interestingly, DXA-based BMD
did not differ between fracture and non-fracture patients. These results suggest that
altered bone marrow fat composition is associated with osteoporotic fractures.
Thus,
1
H-MRS of vertebral bone marrow may serve as a tool for BMD independent
fracture risk assessment. However, future studies are needed to investigate this
association in further detail.
−
7 Summary
Osteoporosis is classi
ed as a public health problem due to its increased risk for
fragility fractures. Computer-assisted diagnostic tools for spine radiographs, DXA
and MDCT images have been developed to support radiologists to correctly
diagnose and report osteoporotic vertebral fractures. The assessment of fracture risk
at the spine is based on the assessment of clinical risk factors and the measurements
of BMD by using DXA or QCT. Standard QCT equivalent BMD values can be
derived from routine contrast-enhanced MDCT examinations without further
radiation exposure. MDCT-based trabecular bone microstructure parameters and
FEMs have shown to improve the prediction of bone strength beyond DXA-based
BMD and revealed pharmacotherapy effects, which were partly not captured by
BMD. Furthermore,
1
H-MRS and chemical shift-based water-fat imaging tech-
niques allow new insights into the vertebral bone marrow metabolism and its
relationship with BMD, bone strength, and other body fat depots.
Con
fl
ict of Interest The authors state no con
fl
ict of interest.
References
1. NIH (2001) NIH consensus development panel on osteoporosis prevention, diagnosis, and
therapy, March 7
-
29, 2000: highlights of the conference. South Med J 94(6):569
-
573
2. Hallberg I, Bachrach-Lindstrom M, Hammerby S, Toss G, Ek AC (2009) Health-related
quality of
life after vertebral or hip fracture: a seven-year
follow-up study. BMC
