Bone marrow perfusion measured with dynamic contrast enhanced magnetic resonance imaging is correlated to body mass index in adults

Bone marrow metabolism is complex and far from being fully understood. Novel aspects, such as the roles of bone marrow adiposity and vascularisation in bone metabolism currently attract attention. There is also a growing interest in the influence obesity might have on bone metabolism. Our objective was to determine the effect of BMI on bone marrow perfusion parameters using dynamic contrast-enhanced magnetic resonance imaging. This prospective monocentric study was approved by our local Ethics committee. Written consent was obtained. The right hip of 59 adults under 60 years old (mean age 37.5) was imaged with a dynamic 3D T1 spoiled gradient echo magnetic resonance imaging sequence. Mean BMI was 24.8 (+/− 4.4). Perfusion parameters were measured in the acetabulum and femoral neck, in the greater trochanter, in the femoral head epiphysis and in the subcutaneous adipose tissue. Associations between perfusion parameters and BMI were studied using a linear mixed model adjusted for age and sex effects. Our results showed that as the BMI increased, the exchanges between blood and bone marrow appeared more important (increased Ktrans and Kep values, p = 0.018 and p = 0.002 respectively) and the intramedullary blood flow appeared increased (lower time to peak values, p = 0.0002). In the subcutaneous fat, as the BMI increased, the vascularization decreased (lower area under the curve and initial slope values, p = 0.019 and p = 0.013 respectively). These results suggest that there is a relation between bone marrow perfusion and BMI, and that subcutaneous fat and bone marrow fat have different microvascular behaviours. Researchers must be aware of the effect of BMI on bone marrow perfusion parameters when they build a MR research protocol and analyse their data. A better understanding of these findings may provide the basis for the management of obesity-related bone changes.