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Rapid increase in marrow fat content and decrease in marrow perfusion in lumbar vertebra following bilateral oophorectomy: an MR imaging-based prospective longitudinal study.

Wáng YX, Griffith JF, Deng M, Yeung DK, Yuan J - Korean J Radiol (2015)

Bottom Line: Bilateral oophorectomy leads to reduced bone mineral density (BMD), and reduced BMD is associated with increased marrow fat and reduced marrow perfusion.Friedman test showed a significant trend for these changes (p < 0.05).Bilateral oophorectomy leads to a rapid decrease in lumbar BMD, an increase in marrow fat content, and a decrease in marrow blood perfusion.

View Article: PubMed Central - PubMed

Affiliation: Department of Imaging & Interventional Radiology, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, N.T., Hong Kong SAR, China.

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.

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Enhancement slope (Eslope) during course of study.
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Figure 6: Enhancement slope (Eslope) during course of study.

Mentions: No vertebral fracture or other spinal disorder was present in any patient. The longitudinal results of BMD, vertebral marrow FF, Emax, and Eslope were shown in Table 1 and Figures 1, 2, 3, 4, 5, 6. There was a sharp decrease in BMD, a sharp increase in marrow FF, and a sharp decrease in Emax, and Eslope during the initial 3 months followed bilateral oophorectomy. BMD and marrow perfusion continued to decrease, and marrow FF continued to increase, though at a slower rate during the later follow-up period. These changes were concomitant. Friedman test showed a statistically significant trend among different examination time points (Table 2).


Rapid increase in marrow fat content and decrease in marrow perfusion in lumbar vertebra following bilateral oophorectomy: an MR imaging-based prospective longitudinal study.

Wáng YX, Griffith JF, Deng M, Yeung DK, Yuan J - Korean J Radiol (2015)

Enhancement slope (Eslope) during course of study.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4296264&req=5

Figure 6: Enhancement slope (Eslope) during course of study.
Mentions: No vertebral fracture or other spinal disorder was present in any patient. The longitudinal results of BMD, vertebral marrow FF, Emax, and Eslope were shown in Table 1 and Figures 1, 2, 3, 4, 5, 6. There was a sharp decrease in BMD, a sharp increase in marrow FF, and a sharp decrease in Emax, and Eslope during the initial 3 months followed bilateral oophorectomy. BMD and marrow perfusion continued to decrease, and marrow FF continued to increase, though at a slower rate during the later follow-up period. These changes were concomitant. Friedman test showed a statistically significant trend among different examination time points (Table 2).

Bottom Line: Bilateral oophorectomy leads to reduced bone mineral density (BMD), and reduced BMD is associated with increased marrow fat and reduced marrow perfusion.Friedman test showed a significant trend for these changes (p < 0.05).Bilateral oophorectomy leads to a rapid decrease in lumbar BMD, an increase in marrow fat content, and a decrease in marrow blood perfusion.

View Article: PubMed Central - PubMed

Affiliation: Department of Imaging & Interventional Radiology, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, N.T., Hong Kong SAR, China.

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.

Show MeSH