Learning objectives
To review the normal developmentalchanges in the bone marrow during skeletal maturation.
To highlight common imaging pitfalls that should not be confused with pathology.
Background
Skeletal growth and maturation is a dynamic process,
with normal changes that must be differentiated from pathologic processes.
The bone marrow is one of the largest organs in the body,
it’s highly cellular and is the main site of hematopoiesis.
Its transformation occurs in a predictable pattern,
both in the long bones of the body as a whole and in each individual bone.
These normal developmental changes of the bone marrow that occurs during skeletal maturation must be understood to differentiate them from disease.
At...
Imaging findings OR Procedure Details
The normal bone marrow and MR Imaging
Normal bone marrow consists primarily of three elements: a bony trabecular matrix,
myeloid tissue,
and adipose cells.
Marrow can be classified into hematopoietic (red) and fatty (yellow) types,
depending on chemical and cellular composition.
Red marrow represents the hematopoietic portion of the bone marrow,
with roughly 60% hematopoietic cells,
and consists of approximately 40% water,
40% fat,
and 20% protein.
Yellow marrow probably provides surface and/or nutritional support for the red marrow.
It contains approximately 15% water,
80%...
Conclusion
MRI is an extremely valuable tool in pediatric patients and the bone marrow is visible in every MR imaging study.
The bone marrow is a dynamic organ with changes in compositionoccurring throughout life in a predictable pattern.Therefore radiologists must be aware of the possible spectrum of normal MR variants,
as any deviation from the predictable pattern of conversion can suggest underlying disease.
Accurate recognition of these particularitieswill help to differentiate normal growth from disease.
References
1.
Chan BY,
Gill KG,
Rebsamen SL,
Nguyen JC.
MR Imaging of Pediatric Bone Marrow.
RadioGraphics.
2016; 36:1911–1930.
2.
Laor T,
Jaramillo D.
MR Imaging Insights into Skeletal Maturation: What Is Normal?.
Radiology.
2009; 250: 28–38.
3.
Burdiles A,
Babyn PS.
Pediatric Bone Marrow MR Imaging.
Magn Reson Imaging Clin N Am.
2009; 17: 391–409.
4.
Mirowitz SA,
Apicella P,
Reinus WR.
MR imaging of bone marrow lesions: relative conspicuousness on T1-weighted,
fat-suppressed T2-weighted,
and STIR images.
AJR Am J Roentgenol.
1994; 162:215—21.
5.
Herrmann...