Type:
Educational Exhibit
Keywords:
Education and training, Image compression, Education, Diagnostic procedure, MR, Neuroradiology spine, Musculoskeletal bone, Bones
Authors:
M. E. Scherer1, S. Centofante1, E. Rossetto2, V. Alarcon3, P. Schvartzman1, C. R. Deragopyan1; 1Buenos Aires/AR, 2Buenos Aires, Capital Federal/AR, 3Capital Federal/AR
DOI:
10.26044/ecr2019/C-2792
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 marrow pattern depends on a careful review of the images weighted in T1.
*The weighting of T2 must be done with STIR sequences or suppressed fat.
*Always get images of chemical change; they are invaluable for determining the presence of red marrow and differentiating it from malignant lesions.
*Contrast enhanced T1 sequences allows quantitative evaluation and help to distinguish bening to malignant processes.
Enhanced contrast T1 with fat suppression increase the visibility of the lesion.
*Diffusion-weighted images (always including b values greater than 500 s / mm 2) can provide valuable information related to the characterization of the lesion,
the response to treatment and the differentiation between benign and malignant vertebral fractures,
including the “Claw sign” in Modic changes.