Learning objectives
To illustrate the main imaging characteristics of bone marrow changes in physiological and pathological processes.
To Provide a guide in order to discriminate the different characteristics about the bone marrow and help to clarify the important features to make a correct differential diagnosis of normal and pathologic patterns on MRI.
Background
The appearance of bone marrow on MRI is determined by the predominant components.
Red marrow is characterized by high water composition (40%) and cellularity,
which translates in low signal on T1 and high signal intensity on STIR or T2-FS sequences.
Yellow marrow as predominant fat composition (80%),
and a small fraction of red marrow elements,
showing high signal on T1 sequences.
MRI is the imaging modality of choice for the investigation of bone marrow disorders.
We provide some key points:
*The assignment of a bone...
Findings and procedure details
We made a retrospective analysis of 78 patients from 2016 to 2018 performed with 1.5 and 3T MR,
including pediatrics and adults,
who showed particular findings in bone marrow,
correlating the imaging characteristics and etiology.
Physiological bone marrow changes
[Fig.
1].
Red to yellow marrow conversion patterns
* Skeleton: peripheral ->central
* Long bones: epiphysis ->diaphysis ->distal metaphysis ->proximal metaphysis
Reconversion of Yellow to Red Marrow
Characterized by the reverse sequence of events that occur during physiologic red to yellow marrow conversion: loss of the...
Conclusion
The knowledge of the physiological and abnormal changes in the bone marrow are essential to understand the image patterns visualized on many pathologies as well as post therapeutics findings,
in order to make a correct differential diagnosis and guide toward an appropriate treatment recommendation.
Although MRI results often cannot determine the specific underlying condition.
Therefore,
correlation with clinical history,
age,
laboratory data,
and complementary studies are required.
In many cases,
biopsy is mandatory.
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