Korean J Radiol.  2015 Feb;16(1):154-159. 10.3348/kjr.2015.16.1.154.

Rapid Increase in Marrow Fat Content and Decrease in Marrow Perfusion in Lumbar Vertebra Following Bilateral Oophorectomy: An MR Imaging-Based Prospective Longitudinal Study

Affiliations
  • 1Department of Imaging & Interventional Radiology, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, N.T., Hong Kong SAR, China. yixiang_wang@cuhk.edu.hk

Abstract


OBJECTIVE
Bilateral oophorectomy leads to reduced bone mineral density (BMD), and reduced BMD is associated with increased marrow fat and reduced marrow perfusion. Purpose of this study was to investigate how soon these changes occur following surgical oophorectomy.
MATERIALS AND METHODS
Six patients who underwent hysterectomy and bilateral salpingo-oophorectomy were studied. At baseline, mean patient age was 49.5 years (range: 45-54 years). Third lumbar vertebral body BMD measurement using quantitative CT, marrow fat fraction (FF) using MR spectroscopy and marrow perfusion using dynamic contrast enhanced MRI were conducted immediately prior to surgery and at 3, 9, and 21 months after surgery.
RESULTS
Reduced BMD, increased marrow FF, and reduced marrow perfusion occurred synchronously post-oophorectomy. There was a sharp decrease of 12.5 +/- 7.2% in BMD (n = 6), a sharp increase of 92.2 +/- 46.3% (n = 6) in FF, a sharp decrease of 23.6 +/- 3.9% in maximum contrast enhancement (n = 5), and of 45.4 +/- 7.7% for enhancement slope (n = 5) during the initial 3 months post surgery. BMD and marrow perfusion continued to decrease, and marrow FF continued to increase at a slower rate during the following 18 months. Friedman test showed a significant trend for these changes (p < 0.05).
CONCLUSION
Bilateral oophorectomy leads to a rapid decrease in lumbar BMD, an increase in marrow fat content, and a decrease in marrow blood perfusion.

Keyword

Oophorectomy; Bone mineral density; Blood perfusion; Marrow fact content; Magnetic resonance

MeSH Terms

Body Mass Index
Bone Density
Bone Marrow/*metabolism
Contrast Media/diagnostic use
Female
Humans
Hysterectomy
Lipids/analysis
Longitudinal Studies
Lumbar Vertebrae/*radiography
*Magnetic Resonance Imaging
Middle Aged
Ovariectomy
Prospective Studies
Contrast Media
Lipids

Figure

  • Fig. 1 Lumbar vertebral bone mineral density (BMD) during course of study.

  • Fig. 2 Typical MR spectra presentation of marrow fat fraction increase post oophorectomy. Water peak is at 4.65 ppm and lipid peak is at 1.3 ppm.

  • Fig. 3 Fat fraction (FF) changes during course of study.

  • Fig. 4 Typical time-intensity enhancement curve at baseline (top trace) and 3 months post oophorectomy (bottom trace). Time-intensity curve post surgery shows reduced Emax and less steep Eslope.

  • Fig. 5 Maximum enhancement (Emax) during course of study.

  • Fig. 6 Enhancement slope (Eslope) during course of study.


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