Aykut Recep Aktaş, İlker Günyeli, Tuna Parpar, Ömer Yılmaz, Mustafa Kayan, Mert Köroğlu, Bumin Değirmenci, Meltem Çetin, Nisa Ünlü, Ayşe Kumul, Hakan Demirtaş, Mustafa Kara

Hormon replasman tedavisi ile vertebralarda homojen olmayan osteoporotik değişiklikler

Amaç: Manyetik rezonans (MR) görüntüleme kullanarak menapoz sonrası hormon tedavisi ile bel omurgasında oluşan fizyolojik değişiklikleri incelemekGereç ve Yöntem: Menopoz sonrası 110 kadın hastaya kemik mineral yoğunluğu (KMY) ölçümü ve standart lomber MRG tetkiki yapıldı. Hastalar KMY ölçümüne göre normal, osteopeni ve osteoporoz olarak guruplara ayırıldı. Ayrıca bu hastalar hormon tedavisi alan ve hormon tedavisi almayan olarak da iki gruba ayırıldı. Lomber MR tetkikinde orta sagital düzlemde T1 ve T2 ağırlıklı sekanslardan her lomber vertebranın merkezine ilgili alan birimi (ROI) yerleştirilerek sinyal değerleri ölçüldü ve ortalamaları hesaplandı. Lomber MR verilerinden elde edilen ortalama sinyal değerleri ile yaş ve KMY değerleri Pearson korelasyon katsayısı kullanılarak incelendi.Bulgular: Tüm menapoz sonrası ve hormon tedavisi almayan olgularda lomber vertebra MR sinyal değerleri ile KMY değerleri arasında korelasyon bulunmamıştır. Ancak hormon tedavisi alan menapoz sonrası kadınlarda minimal korelasyon saptanmıştır. KMY değerleri ile yaş arasında negatif korelasyon varken T1 ve T2 ağırlıklı sinyal değerlerinin yaş ile ilişkili olmadığı bulunmuştur.Sonuç: Bel omurlarının merkezinin daha fazla vasküler yapı içermesi nedeniyle HRT alanların osteoporozdan daha geç ve az etkilendiği düşünülmüştür. Bu çalışma, hormon tedavisinin menapoz sonrasında kompresyon kırıklarından koruyabileceğini gösterebilir.

Anahtar Kelimeler:

osteoporoz, osteopeni, manyetik rezonans görüntüleme, vertebra, kırıklar

Inhomogeneous osteoporotic changes of vertebrae with hormone replacement therapy

Background and Aim: To evaluate postmenopausal physiological bone marrow changes with hormone replacement therapy(HRT) of the lumbar spine using magnetic resonance (MR) imaging. Materials and Methods: BMD measurement and lumbar spine MR imaging performed in 110 postmenopausal women (PW). Women were classified as normal, osteopathic and osteoporotic. These patients grouped according to women who were and women who were not receiving HRT. Mean intensity from the center of each lumbar vertebrae at the mid-sagital plane in a region of interest (ROI), measured and calculated from MR image data. Correlation between T1 and T2 intensities with age and BMD evaluated using Pearson's correlation coefficient. Results: No significant positive correlation found between BMD and T1, T2 intensity among all PW and PW who were not using HRT. However there was a correlation between T1,T2 intensities and BMD in PW receiving HRT. BMD was inversely correlated with age. No significant correlation found between the T1, T2 intensities of bone marrow at the center of the vertebrae and BMD.Conclusion: The center of the lumbar vertebrae is probably less and lately affected from fatty transformation by the help of HRT. This study may Show that postmenopausal hormone theraphy may protect vertebrae from compression fractures.

Keywords:

osteoporosis, osteopenia, magnetic resonans imaging, lumbar vertebrae, fractures,

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