OBJECTIVE

To investigate the relationships of T₂-corrected 6-echo Dixon volumetric interpolated breath-hold examination (VIBE) imaging-based fat fraction (FF) and R₂ values with bone mineral density (BMD); determine their associations with sex, age, and menopause; and evaluate the diagnostic performance of the FF and R₂ for predicting osteopenia and osteoporosis.

MATERIALS AND METHODS

This study included 153 subjects who had undergone magnetic resonance (MR) imaging, including MR spectroscopy (MRS) and T₂-corrected 6-echo Dixon VIBE imaging. The FF and R₂ were measured at the L4 vertebra. The male and female groups were divided into two subgroups according to age or menopause. Lin's concordance and Pearson's correlation coefficients, Bland-Altman 95% limits of agreement, and the area under the curve (AUC) were calculated.

RESULTS

The correlation between the spectroscopic and 6-echo Dixon VIBE imaging-based FF values was statistically significant for both readers (p = 0.940 [reader 1], 0.908 [reader 2]; both < 0.001). A small measurement bias was observed for the MRS-based FF for both readers (mean difference = -0.3% [reader 1], 0.1% [reader 2]). We found a moderate negative correlation between BMD and the FF ( = -0.411 [reader 1], -0.436 [reader 2]; both < 0.001) with younger men and premenopausal women showing higher correlations. R₂ and BMD were more significantly correlated in women than in men, and the highest correlation was observed in postmenopausal women ( = 0.626 [reader 1], 0.644 [reader 2]; both < 0.001). For predicting osteopenia and osteoporosis, the FF had a higher AUC in men and R₂ had a higher AUC in women. The AUC for predicting osteoporosis was highest with a combination of the FF and R₂ in postmenopausal women (AUC = 0.872 [reader 1], 0.867 [reader 2]; both < 0.001).

CONCLUSION

The FF and R₂ measured using T₂-corrected 6-echo Dixon VIBE imaging can serve as predictors of osteopenia and osteoporosis. R₂ might be useful for predicting osteoporosis, especially in postmenopausal women.