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Apports physiopathologiques de l’étude de la perfusion de la moëlle osseuse par IRM

Abstract : Bone Marrow (BM) microvascular properties are insufficently known in humans. Dynamic-Contrast Enhanced (DCE) MRI allows its non-invasive quantitative assessment. We concentrated on the hip because this joint is frequently affected by debilitating pathologies such as osteoarthritis. Their early diagnosis is a current medical challenge. We implemented a 3D DCE-MRI sequence with isotropic voxels, high spatial resolution and a large coverage. It was used in a study of 60 patients aged 18 to 60, with no previous history of bone disease and with normal-appearing BM on MR images. Semi-quantitative and pharmacokinetic parameters were measured in 15 regions of interest in each patient. All the parameters were different between red and yellow BM. Perfusion was different between acetabular (axial skeleton) and femoral intertrochanteric (appendicular skeleton) BMs. Several parameters were negatively correlated with age. Perfusion was different in men and women. The femoral head perfusion was heterogeneous, likely because of mechanical load exposure. Ktrans, Kep and TTP were correlated with body mass index. This suggests that obesity influences BM metabolism. Smoking and hypercholesterolemia influenced these same parameters in several zones. We hypothesized that these parameters might reflect BM microvascular aletrations. Our results open new research perspectives both in the physiology and pathology of BM.
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Jean-François Budzik. Apports physiopathologiques de l’étude de la perfusion de la moëlle osseuse par IRM. Médecine humaine et pathologie. Université du Droit et de la Santé - Lille II, 2015. Français. ⟨NNT : 2015LIL2S011⟩. ⟨tel-01261678⟩

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