Budzik Jean-François, Lefebvre Guillaume, Behal Hélène, Verclytte Sébastien, Hardouin Pierre, Teixeira Pedro, Cotten Anne
Lille Catholic Hospitals, Imaging Department, Lille Catholic University, Lille, France; PMOI Physiopathology of Inflammatory Bone Diseases, EA 4490, Lille, France.
Lille Regional University Hospital, Musculoskeletal Imaging Department, University of Lille Nord de France, Lille, France.
Bone. 2017 Jun;99:47-52. doi: 10.1016/j.bone.2017.03.048. Epub 2017 Mar 24.
Bone marrow metabolism is complex and far from being fully understood. Novel aspects, such as the roles of bone marrow adiposity and vascularisation in bone metabolism currently attract attention. There is also a growing interest in the influence obesity might have on bone metabolism. Our objective was to determine the effect of BMI on bone marrow perfusion parameters using dynamic contrast-enhanced magnetic resonance imaging. This prospective monocentric study was approved by our local Ethics committee. Written consent was obtained. The right hip of 59 adults under 60years old (mean age 37.5) was imaged with a dynamic 3D T1 spoiled gradient echo magnetic resonance imaging sequence. Mean BMI was 24.8 (+/-4.4). Perfusion parameters were measured in the acetabulum and femoral neck, in the greater trochanter, in the femoral head epiphysis and in the subcutaneous adipose tissue. Associations between perfusion parameters and BMI were studied using a linear mixed model adjusted for age and sex effects. Our results showed that as the BMI increased, the exchanges between blood and bone marrow appeared more important (increased K and K values, p=0.018 and p=0.002 respectively) and the intramedullary blood flow appeared increased (lower time to peak values, p=0.0002). In the subcutaneous fat, as the BMI increased, the vascularization decreased (lower area under the curve and initial slope values, p=0.019 and p=0.013 respectively). These results suggest that there is a relation between bone marrow perfusion and BMI, and that subcutaneous fat and bone marrow fat have different microvascular behaviours. Researchers must be aware of the effect of BMI on bone marrow perfusion parameters when they build a MR research protocol and analyse their data. A better understanding of these findings may provide the basis for the management of obesity-related bone changes.
骨髓代谢复杂，远未被完全理解。骨髓脂肪化和血管生成在骨代谢中的作用等新方面目前备受关注。肥胖对骨代谢可能产生的影响也越来越受到关注。我们的目的是使用动态对比增强磁共振成像来确定体重指数（BMI）对骨髓灌注参数的影响。这项前瞻性单中心研究获得了当地伦理委员会的批准。已获得书面知情同意。对59名60岁以下（平均年龄37.5岁）的成年人的右髋部进行了动态三维T1扰相梯度回波磁共振成像序列扫描。平均BMI为24.8（±4.4）。在髋臼、股骨颈、大转子、股骨头骨骺和皮下脂肪组织中测量灌注参数。使用针对年龄和性别效应进行调整的线性混合模型研究灌注参数与BMI之间的关联。我们的结果表明，随着BMI的增加，血液与骨髓之间的交换显得更为重要（K值和K*值增加，分别为p = 0.018和p = 0.002），并且髓内血流增加（达峰时间值降低，p = 0.0002）。在皮下脂肪中，随着BMI的增加，血管生成减少（曲线下面积和初始斜率值降低，分别为p = 0.019和p = 0.013）。这些结果表明骨髓灌注与BMI之间存在关联，并且皮下脂肪和骨髓脂肪具有不同的微血管行为。研究人员在制定磁共振研究方案和分析数据时必须意识到BMI对骨髓灌注参数的影响。对这些发现的更好理解可能为肥胖相关骨变化的管理提供依据。
