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. 2016 Jun;34(5):632-7.
doi: 10.1016/j.mri.2015.12.034. Epub 2015 Dec 23.

Quantification of bone marrow water and lipid composition in anterior cruciate ligament-injured and osteoarthritic knees using three-dimensional magnetic resonance spectroscopic imaging

Lauren S Tufts  1 , Keerthi Shet  2 , Fei Liang  3 , Sharmila Majumdar  4 , Xiaojuan Li  5
Affiliations

Quantification of bone marrow water and lipid composition in anterior cruciate ligament-injured and osteoarthritic knees using three-dimensional magnetic resonance spectroscopic imaging

Lauren S Tufts et al. Magn Reson Imaging. 2016 Jun.

Abstract

Purpose: To quantitatively evaluate longitudinal changes in water and lipid in knee bone marrow with and without bone marrow edema-like lesions (BMELs) in subjects with acutely ruptured anterior cruciate ligaments (ACLs) or osteoarthritis (OA) using three-dimensional magnetic resonance spectroscopic imaging (3D MRSI).

Material and methods: Ten ACL and 10 OA subjects who presented with BMEL and seven BMEL-free controls were scanned at 3T. All ACL and OA subjects had one-year follow-up scans. 3D MRSI was acquired in BMEL and adjacent bone marrow, and water content (WC) and unsaturated lipid index (UI) were calculated in each region of interest.

Results: At baseline, ACL BMEL WC was significantly higher than ACL non-BMEL, OA BMEL, and control WC; ACL non-BMEL WC, ACL BMEL UI, and OA BMEL WC were significantly higher than control. ACL BMEL WC decreased significantly one year post-reconstruction; UI decreased non-significantly (p=0.09). No significant changes in OA BMEL or ACL and OA non-BMEL WC and UI were observed.

Conclusion: 3D MRSI is a powerful method of quantitatively assessing the biochemical composition of bone marrow in OA and ACL-injured knees, which may serve as imaging markers to improve comprehension of primary and secondary OA pathology.

Keywords: Anterior cruciate ligament tear; Bone marrow; Bone marrow edema-like lesions; Knee; Osteoarthritis; Three-dimensional magnetic resonance spectroscopic imaging.

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Figures

Figure 1
Figure 1
Demonstration of the longitudinal biochemical analysis of the BMEL region (outlined in yellow). Regardless of whether (a, b) the baseline BMEL volume (c) increased or (d) decreased at follow-up, only the voxels that completely overlaid identical regions of BMEL-containing bone marrow at both timepoints (shaded red) were considered. Sample spectra of a voxel (e) with and (f) without BMEL (shaded red and green in 1b, respectively). BMEL-free bone marrow spectra are largely dominated by the saturated lipid peak at 1.3 ppm. BMEL bone marrow spectra show marked elevation of water and unsaturated lipid levels at 4.65 and 5.35 ppm, respectively. BMEL: bone marrow edema-like lesion
Figure 2
Figure 2
Comparison of baseline (a) WC and (b) UI between ACL and OA BMEL and non-BMEL regions and control (*p < 0.05). WC = water content; UI = unsaturation index; BMEL = bone marrow edema-like lesion.
Figure 3
Figure 3
Longitudinal BMEL WC and UI changes in (a) the complete ACL cohort, (b) the five ACL-injured subjects who returned for a two-year follow-up scan, and (c) the complete OA cohort. (*p < 0.05). WC: water content; UI: unsaturation index; BMEL: bone marrow edema-like lesion.
See this image and copyright information in PMC

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