Assessment of the diagnostic contribution of hip T1-weighted magnetic resonance imaging in the diagnosi̇s of osteoporosis

Introduction and purpose: This study aimed to show the contribution of T1W imaging findings obtained in routine hip MRI to the diagnosis of osteoporosis-osteopenia by comparing them with DEXA results. Materials and Methods: The study included 330 patients, male and female, aged 18 to 99, who underwent DEXA at Ankara Bilkent City Hospital Radiology Clinic between 15 February 2019 and 1 May 2023, and who had a hip MRI within 6 months. The control group included 190 female patients aged 20-29 years with a normal body mass index (19-25 kg/m2), no known disease, and normal hip MRI. Patients with cancer, metabolic bone disease, a history of fracture, on systemic corticosteroids, and those whose images were unsuitable for evaluation were all excluded from the study. Two radiologists who were not aware of the DEXA results evaluated the images retrospectively. M scores for SNR, SMR, and SFR were calculated by measuring the signal intensities of femur regions, subcutaneous fat, and muscle intensities, as well as noise from the artifact-free area. Correlation, regression, and ROC analysis were performed for SNR, SMR, and SFR and for all M scores. Results: The average age of the study participants was 57.61, and 27 (8.1%) had femoral neck osteoporosis and 30 (9.1%) had total hip osteoporosis. There was a statistically significant difference in SNR, SFR, SMR, and M scores between the osteoporosis, osteopenia, and normal groups. M-scores and T-scores have a strong negative correlation for the neck (SNR-M-r=-0.722, SFR-M-r=-0.750, SMR-M-r=-0.662 P0.001) and a moderate negative correlation for the total hip (SNR-M-r=-0.599, SFR-M-r=-0.625, SMR-M-r=-0.568 P0.001). Cut-off points for femoral neck osteoporosis detection were determined as follows: SNR-M-score=2.23 (sensitivity 93%, specificity 71%), SFR-M-score=3.052 (sensitivity 84.37%, specificity 85%), and SMR-score=1.538 (sensitivity 100%, specificity 78%). And cut-off points for hip were determined as: SNR-M-score=1.22 (sensitivity 85%, specificity 68%), SFR-M-score=1.313 (sensitivity 75%, specificity 82%), and SMR-score=1.576 (sensitivity 67%, specificity 83%). Conclusion: It has been shown that the signal ratios and M scores obtained from T1W images in routine hip MRI scans may be useful in the diagnosis and prediction of osteoporosis and osteopenia.