Ultra-high Field MRI Microarchitecture Analysis Improves the Prediction of Proximal Femur Fracture: A Combined Study with Ex Vivo Biomechanical Tests

• Guenoun Daphne
• Pithioux Martine
• Souplet Jean-Christophe
• Guis Sandrine
• Corroller Thomas Le
• Fouré Alaxandre
• Pauly Vanessa
• Mattei Jean-Pierre
• Bernard Monique
• Guye Maxime
• Chabrand Patrick
• Champsaur Pierre
• Bendahan David

The purpose of this study was to investigate bone microarchitecture of cadaveric proximal femurs using ultra-high field (UHF) 7-Tesla magnetic resonance imaging (MRI) and to compare the corresponding metrics with failure load assessed during mechanical compression test and areal bone mineral density (ABDM) measured using dual-energy X-ray absorptiometry. Materials and methods: ABDM of ten proximal femurs from five cadavers (5 women; mean age= 86.2 ± 3.8 (SD) years; range : 82.5-90 years) were investigated using dual-energy X-ray absorptiometry and the bone volume fraction, trabecular thickness, trabecular spacing, fractal dimension, Euler characteristics, Connectivity density and degree of anisotropy of each femur was quantified using UHF MRI. The whole set of specimens underwent mechanical compression tests to failure. Associations were searched using correlation tests and multiple regression analysis.