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1.
MRI of bone marrow disorders 总被引:14,自引:0,他引:14
Four factors can be used in MR of bone marrow: fat–water distribution, artifacts induced by bone trabeculae, diffusion, and
uptake of contrast media. Fat–water is imaged using T1-weighted spin-echo, short tau inversion recovery (STIR), and fast STIR,
in- and out-of-phase gradient echo, and fat pre-saturation sequences; bone trabeculae by gradient echo with long TE; diffusion
by single-shot spin-echo. The injection of contrast media is a more easy and efficient way to improve the specificity. The
value and limitations of those sequences are discussed in marrow replacements (metastases, lymphoma, leukemia) and in myeloid
hyperplasia or depletion. 相似文献
2.
3.
Ribrag V Vanel D Leboulleux S Lumbroso J Couanet D Bonniaud G Aupérin A Masson F Bosq J Edeline V Fermé C Pigneur F Schlumberger M 《European journal of radiology》2008,66(2):325-331
PURPOSE: Initial lymphoma staging requires bone marrow assessment in aggressive lymphomas. Bone marrow lymphoma infiltration is routinely assessed by bone marrow biopsy (BMB), considered as the "gold standard". The aim of this study was to compare the performance of BMB, whole-body MRI and PET/CT for evaluation of BM infiltration. METHODS: Patients with newly diagnosed aggressive lymphoma were evaluated by BMB, MRI and PET/CT. Two radiologists, two nuclear medicine physicians and one pathologist independently assessed the results of the three modalities. Bone was considered as involved if BM was positive or if PET/CT or MRI was positive and if there was a resolution of the abnormal image shown on PET/CT or MRI halfway or at the end of therapy. RESULTS: Both MRI and PET/CT detected bone marrow lesions in the 9/43 patients, but two patients with multiple lesions had more lesions detected by PET/CT compared to MRI. Among these nine patients, two with an iliac crest lesion detected by both MRI and PET/CT had bone marrow involvement with large-cell lymphoma on histological examination. The other seven patients had focal MRI and PET/CT lesions in areas other than the iliac crest, where the blind BMB was done. The other patients had bone marrow without large-cell lymphoma involvement. In all cases, after lymphoma therapy bone marrow involvement regressed on histological examination, PET and MRI. CONCLUSION: These preliminary results suggest that non-invasive morphological procedures could be superior to BMB for bone marrow assessment in aggressive lymphomas. Ongoing study is underway to validate these results. 相似文献
4.
Effect of superparamagnetic iron oxide on bone marrow 总被引:1,自引:0,他引:1
The goal of this study was to compare the effects of SPIO particles on the signal intensity of the bone marrow of the vertebra
spine in patients with and without liver cirrhosis. Forty-eight patients with normal liver tissue and 56 patients with liver
cirrhosis were examined before and after intravenous SPIO administration, using a 1.5-T system (Magnetom Vision, Siemens,
Erlangen, Germany) with a semiflexible cp-array coil. Three different pulse sequences were applied: a T1-weighted gradient-echo
sequence, a T2-weighted fast spin-echo sequence with spectral fat suppression and a T2*-weighted gradient-echo sequence. The signal-to-noise ratio (SNR) of the liver, vertebra bone and paraspinal muscle were obtained.
The SNR value change in each patient group and the SNR value difference between the two groups were evaluated. For assessment
of statistical significance, Student's t-test with a level of p < 0.05 was applied. No significant differences in the SNR values of the liver and bone marrow between the two groups could
be seen with any of the three sequences precontrast. Using the T1-weighted gradient-echo sequence in the noncirrhotic liver
group, pre- and postcontrast comparisons of the SNR values of the liver and bone marrow indicated a decrease of approximately
–44.3 % (p = 0.02) and increase of approximately 15.3 % (p = 0.04), respectively. No significant change was seen in the cirrhotic liver group. With the T2-weighted fast spin-echo sequence,
a significant decrease of the SNR value of the liver and the bone marrow in both groups was seen. With the T2*-weighted gradient-echo sequence, the signal intensity decrease of the normal liver tissue was approximately –65.6 % (p = 0.00), in cirrhotic liver tissue the decrease was –29.9 % (p = 0.02). The SNR values of the bone marrow showed a decrease of –27.8 % (p = 0.04) in the noncirrhotic liver group, whereas in the cirrhotic liver group it was only –11.3 % and statistically not significant.
The effect of SPIO particles on the liver and bone marrow is significantly less in patients with liver cirrhosis.
Received: 2 April 1999; Revised: 5 October 1999; Accepted: 2 February 2000 相似文献
5.
Frédéric E. Lecouvet Pierre De Nayer Christian Garbar Henri Noël Jacques Malghem Baudouin E. Maldague Bruno C. Vande Berg 《Skeletal radiology》1998,27(12):692-695
Two cases of treated plasma cell lesions of bone are reported for which contrast-enhanced MRI had suggested necrosis, based
on lack of enhancement after gadolinium injection, and in which pathologic examinations revealed the presence of extensive
viable neoplastic tissue. These cases highlight the need for cautious interpretation of contrast-enhanced MRI signs of response
to treatment and inactivity of lesions in the setting of plasma cell neoplasms. 相似文献
6.
Desmoplastic fibroma of bone: MRI features 总被引:5,自引:0,他引:5
Vanhoenacker FM Hauben E De Beuckeleer LH Willemen D Van Marck E De Schepper AM 《Skeletal radiology》2000,29(3):171-175
Desmoplastic fibroma of bone is a very rare benign tumor, which may be locally aggressive. In contrast to the well-documented
radiological appearance, the literature on MR imaging features of this tumor is scarce. The MR imaging characteristics in
our case are compared to those previously reported. Although there is a considerable overlap in the MR imaging features with
other bone tumors, an interesting MR feature of desmoplastic fibroma is the presence of low to intermediate signal intensity
foci on T2-weighted images, which radiographically does not correspond to calcifications. This feature may help narrow the
differential diagnosis.
Received: 24 May 1999 Revision requested: 30 June 1999 Revision received: 8 October 1999 Accepted: 14 October 1999 相似文献
7.
MRI of the marrow in the paediatric skeleton 总被引:1,自引:0,他引:1
Magnetic resonance imaging (MRI) has greatly advanced evaluation of marrow diseases of the paediatric skeleton. As with many other aspects of paediatric radiology it is important to recognize the normal variations in the appearance of the marrow that occur in the growing child. These normal variations need to be differentiated from diseases and conditions that affect the marrow. This review describes the normal changes that occur in children with age, and the appearances of the pathological changes seen in infection, infiltration, haematological disorders, transplantation and radiation therapy. 相似文献
8.
C. C. A. Nolte-Ernsting Gerhard Adam Markus Bühne Andreas Prescher Rolf W. Günther 《Skeletal radiology》1996,25(5):413-420
Objective. The objective of this study was to determine the value of MRI in the detection of degenerative bone marrow abnormalities in
an animal osteoarthritis model. Design. In 10 dogs with experimentally induced unilateral osteoarthritis of the knee, MRI was performed using two-dimensional spin-echo
(2D-SE) and three-dimensional gradient-echo (3D-GE) imaging. Contrast enhanced T1-weighted 2D-SE sequences were also obtained
after injection of gadolinium-DTPA. The results were compared with the gross and histopathologic findings and with radiography.
Results. Histopathologic specimens revealed 21 osteosclerotic lesions and 5 intraosseous cysts. On 2D-SE images, 24 of 26 lesions were
detected, while 21 of 26 lesions were identified on 2D-GE sequences. Radiography, including conventional tomography, demonstrated
9 of 26 lesions. Regardless of the sequence weighting, all osteosclerotic lesions appeared hypointense on MRI. Signal loss
in bone sclerosis resulted primarily from the reduction of intact fat marrow, the increased bone density being of secondary
importance. Quantitative signal analysis allowed approximate estimation of the grade of sclerosis. On postcontrast images,
sclerotic bone remained hypointense, although significant but non-specific enhancement relative to the normal fat marrow was
observed. The extent of contrast enhancement did not correlate with the grade of osteosclerosis. All five cysts were readily
diagnosed by MRI. Cysts displayed either central or marginal contrast enhancement within their cavities. Conclusions. MRI provides a sensitive method for the diagnosis of osteoarthritic bone abnormalities, allowing their differentiation from
most non-degenerative subarticular lesions. 相似文献
9.
A comparison of bone scintigraphy and MRI in the early diagnosis of the occult scaphoid waist fracture 总被引:4,自引:0,他引:4
C. Fowler B. Sullivan L. A. Williams G. McCarthy R. Savage A. Palmer 《Skeletal radiology》1998,27(12):683-687
Objective. To determine the accuracy of MRI in the assessment of the radiographically occult scaphoid fracture. Design. This prospective study compared the sensitivity and specificity of MRI for detection of radiographically occult scaphoid
fractures with bone scintigraphy (BS), the currently accepted imaging modality of choice. Consecutive patients with clinical
signs of a scaphoid injury but no evidence of fracture on plain radiographs at presentation and after 7–10 days were evaluated
by MRI and BS. All images were reported in masked fashion and the sensitivities and specificities of the imaging modalities
determined. All patients with a scaphoid fracture demonstrated by MRI or BS were followed for at least a year after injury.
Patients. Forty-three subjects (aged 12–74 years) had both MRI and BS carried out on average 19 days from the injury date. Results and conclusions. Six patients (14%) had scaphoid waist fractures. There were other bony injuries in a further six. In 40 patients there was
agreement between the BS and MRI findings. In three cases there was discrepancy between the imaging modalities; in all three
MRI was found to be the more sensitive and specific. MRI could become the investigation of choice for this injury. 相似文献
10.
目的:探讨椎体骨髓单方向扩散屏气DWI方法,分析急性白血病(AL)患者椎体骨髓浸润DWI的临床应用价值。方法 对42例确诊AL患者和15名健康志愿者行胸腰椎矢状面单次激发回波平面DWI (SS-EPI-DWI)序列扫描(b值为0、650 s/mm2),扩散方向为头-足(S/I)、前-后(A/P)和左-右(R/L)方向,每个方向DWI采集时间均为12s,闭气采集。分别在3个方向的ADC图上测量多个椎体骨髓的ADC值,比较3个扩散方向的ADC值的差别。AL患者分为初发未治疗组13例和治疗组29例[初发治疗未缓解(NR)组7例。初发治疗完全缓解(CR)组8例、治疗巩固组14例]。比较不同治疗阶段AL患者ADC值的差异用方差分析、t检验,ADC值与骨髓原始细胞比例的相关性采用Pearson分析。结果 57例受试者362个椎体S/I、A/P和R/L方向的ADC值分别为(0.758±0.009)、(0.732 ±0.009)、(0.758±0.009)×10-3 mm2/s,三者之间ADC值的差异无统计学意义(F=2.958,P>0.05)。15名健康志愿者94个椎体ADC值为(0.697 ±0.122)×10-3mm2/s,13例初发未治疗组85个椎体ADC值为(0.592±0.071)×10-3mm2/s,两者差异具有统计学意义(t=2.568,P<0.05);29例治疗组AL患者183个椎体ADC值为(0.796±0.225)×10-3mm2/s,与初发未治疗组比较,差异有统计学意义(t= -1.332,P<0.05);初发治疗CR组±巩同治疗组共140个椎体ADC值为(0.786±0.184)×10 -3mm2/s,初发治疗NR组43个椎体ADC值为(0.804±0.327)×10-3mm2/s,两者差异无统计学意义(t= -0.160,P>0.05)。初发未治疗组的S/I ADC值与骨髓象原始细胞比例(中位数26.4%,范围7.9% ~48.2%)呈线性负相关(r= -0.524,P<0.05)。结论 椎体骨髓DWI为各向同性,单方向屏气DWI能提高图像质量。初发AL患者ADC值降低,化疗后ADC值增加,初发组ADC值与骨髓象原始细胞比例呈线性负相关。 相似文献
11.
A comparison of pulse sequences in the detection of post-traumatic bone marrow abnormalities at low field strength MRI 总被引:1,自引:0,他引:1
Objective and patients. One hundred and forty-one patients with recent joint trauma, aged 12–71 years, were imaged on a 0.2-T dedicated MRI system
and evaluated for bone bruises. The most beneficial sequences were compared. Design. The diagnosis of post-traumatic bone marrow abnormalities was established in 20 of 141 patients on the basis of decreased
signal intensity on T1-weighted SE and GRE sequences and increased signal intensity on T2-weighted TSE and fat-suppressed
IRGE sequences. Signal changes within the bone marrow were evaluated and statistically correlated with normal bone. Results. The highest signal alteration was found on T1-weighted SE and GRE sequences, followed by IRGE, which detected smaller differences
in signal intensity. T2-weighted TSE imaging showed the least contrast. The areas with bone marrow changes were approximately
equal in size on T1-weighted SE and T2-weighted TSE sequences. The same areas depicted on IRGE and GRE sequences proved to
be significantly larger (P<0.01). Conclusion. Using a 0.2-T dedicated system T1-weighted SE, T1-weighted GRE and IRGE sequences were most effective in detecting conspicuous
bone marrow alteration, while the T2-weighted TSE sequence was inferior. GRE and IRGE imaging showed areas about 4 times larger
depicting bone marrow changes. On suspicion of bone bruise, a protocol including GRE and IRGE pulse sequences could be most
beneficial. 相似文献
12.
Hwang S Lefkowitz R Landa J Akin O Schwartz LH Cassie C Healey JH Alektiar KM Panicek DM 《Skeletal radiology》2009,38(1):11-19
Objective To determine the prevalence and appearance of magnetic resonance imaging (MRI) signal changes that occur in local bone marrow
after radiation therapy (RT) and/or chemotherapy for extremity soft tissue sarcoma (STS).
Materials and methods Seventy patients with primary STS at the level of a long bone who also had undergone pretreatment MRI and at least one post-treatment
MRI of the tumor bed were identified. MRIs of each patient were retrospectively reviewed for new changes in marrow signal
in the region of the tumor bed and for the morphology, relative signal intensities, heterogeneity, and progression or regression
of changes over time.
Results Focal signal changes in marrow were observed in 26/70 patients (37%) at a median of 9.5 months after RT and/or chemotherapy
and diffuse changes in seven (10%) at a median of 8 months. Patients who received neither RT nor chemotherapy did not develop
marrow changes. Mean RT doses in patients with changes and those without were 5,867 and 6,076 cGy, respectively. In most patients
with focal changes, changes were seen in all sequences and were linear–curvilinear, patchy, or mixed at the level of the tumor
bed. Predominant signal intensity of changes was between muscle and fat at T1WI and between muscle and fluid at fat-saturated
T2WI or short tau inversion recovery. Most focal changes enhanced heterogeneously and increased or fluctuated in size over
time.
Conclusion Changes in MRI appearance of long bone marrow frequently are evident after combined RT and chemotherapy for STS and most commonly
increase or fluctuate in size over time. These changes have various non-mass-like configurations and often show signal intensities
similar to those of red marrow and thus should not be mistaken for metastases. The marrow changes might represent an early
stage of gelatinous transformation of marrow. 相似文献
13.
Objective. Multilevel spinal injury is well recognised. Previous studies reviewing the radiographs of spinal injury patients have shown
an incidence of 15.2% of unsuspected spinal injury. It is recognised that magnetic resonance imaging (MRI) can identify injuries
that are not demonstrated on radiographs. The objective of this study was to determine the incidence and significance of spinal
injuries using MRI in comparison with radiographs.
Design and patients. The radiographs and MR images of 110 acute spinal injury patients were reviewed independently of each other and the findings
were then correlated to determine any unsuspected injury.
Results. MRI detected vertebral body bone bruises (microtrabecular bone injury) in 41.8% of spinal injury patients which were not
seen on radiographs. These bone bruises were best appreciated on sagittal short tau inversion recovery MR sequences and seen
at contiguous and non-contiguous levels in relation to the primary injury.
Conclusion. This level of incidence of bone bruises has not previously been appreciated. We recommend that patients undergoing MRI for
an injured segment of the spine are better assessed by MRI of the entire spine at the same time to exclude further injury.
Received: 17 April 2000 Revision requested: 19 June 2000 Revision received: 6 September 2000 Accepted: 27 November 2000 相似文献
14.
MR imaging of bone marrow infiltration by hematologic malignancies provides non-invasive assays of bone marrow cellularity
and vascularity to supplement the information provided by bone marrow biopsies. This article will review the MR imaging findings
of bone marrow infiltration by hematologic malignancies with special focus on treatment effects. MR imaging findings of the
bone marrow after radiation therapy and chemotherapy will be described. In addition, changes in bone marrow microcirculation
and metabolism after anti-angiogenesis treatment will be reviewed. Finally, new specific imaging techniques for the depiction
of regulatory events that control blood vessel growth and cell proliferation will be discussed. Future developments are directed
to yield comprehensive information about bone marrow structure, function and microenvironment. 相似文献
15.
Imatimid-induced bone marrow necrosis detected on MRI examination and mimicking bone metastases 总被引:1,自引:0,他引:1
Imatinib has revolutionized the treatment and prognosis of patients with gastrointestinal stromal tumors (GIST). In contrast
to liver and/or abdominal involvement, bone metastases are an uncommon event in GIST. We report here two patients with metastatic
GIST who developed pelvic bone marrow focal lesions visible on MRI examinations, while Imatinib dramatically improved other
tumor sites. A biopsy in one patient diagnosed bone marrow necrosis. The other patient had a favorable follow-up over several
years, without bone metastases. Focal bone marrow abnormalities, detected on MRI examinations and mimicking bone metastases
in patients who were otherwise responding, should be considered as probable bone marrow necrosis. 相似文献
16.
During the past two years five patients with malignant primary bone tumors undergoing amputation or resection of the involved bone had preoperative computed tomography (CT) examination of the medullary cavity. The contralateral extremity was used as a control in all cases. The positive attenuation coefficient of the marrow indicated the extent of tumor infiltration. The correlation between the preoperative CT and pathologic measurement ranged between 1–8 mm, an accuracy greater than 94%. 相似文献
17.
Background and purpose
Evaluation of bone marrow infiltration is an essential step in the staging of lymphoma. The accuracy of 18F-fluorodeoxyglucose-positron emission tomography (18F-FDG PET), combined 18F-fluorodeoxyglucose-positron emission tomography/computed tomography (18F-FDG-PET/CT) and magnetic resonance imaging (MRI) in diagnosing bone marrow involvement of lymphoma has never been systematically assessed, and the present systematic review was aimed at this issue.Methods
MEDLINE, EMBASE, Cochrane library and some other databases, from January 1995 to July 2010, were searched for initial studies. All the studies published in English or Chinese relating to the diagnostic value of 18F-FDG PET, PET/CT and MRI for patients with bone marrow involvement of lymphoma were collected. We extracted data to calculate sensitivity, specificity, SROC curves and AUC and to test for heterogeneity. The statistic software called “Meta-Disc 1.4” was used for data analysis.Result
In 32 included studies, PET/CT had the highest pooled sensitivity, 91.6% (95%CI: 85.1, 95.9) and highest pooled specificity, 90.3% (95%CI: 85.9, 93.7). PET/CT also had the highest pooled DOR, 68.89 (95%CI: 15.88, 298.92). The AUC of PET, PET/CT, and MRI were 0.9430, 0.9505 and 0.8764. There was heterogeneity among studies and no evidence of publication bias.Conclusion
PET/CT was a highly sensitive and specific modality in diagnosing patients with bone marrow involvement in lymphoma. Compared with MRI and PET alone, PET/CT can play important roles in the staging of lymphoma. 相似文献18.
淋巴瘤是一种血液系统恶性肿瘤。淋巴瘤骨髓浸润(BMI)使疾病分期上升至IV期, 是疾病进展、预后较差的标志。常规部位的骨髓活检(BMB)具有创伤性, 且检出率低。PET/CT与全身MRI的出现, 丰富了BMI的检测手段。PET/CT与全身MRI对于淋巴瘤, 尤其是侵袭性淋巴瘤BMI均具有较高的检出率, 二者孰高孰低, 尚未定论。对于红骨髓、良性骨髓病变(炎症等)、淋巴瘤BMI病灶以及肿瘤治疗后骨髓的变化与骨髓残留或复发病灶, 全身MRI很难区分, 而PET/CT却可以很好地鉴别这些病灶。但是, PET/CT存在电离辐射; 对于惰性淋巴瘤的BMI, 超出PET/CT分辨率的病灶, 可能出现假阴性; 某些情况会限制PET/CT的使用, 包括18F-FDG生理性摄取量可能发生改变的正常组织、18F-FDG摄取相关性炎症、高血糖或高胰岛素血症导致的18F-FDG分布的改变、肿瘤患者治疗后出现的骨髓活化等。然而, 这些情况可以使用全身MRI。因此, 全身MRI和PET/CT相辅相成, 优势互补, 但二者均不能代替BMB。对于常规BMB阴性, 但影像学提示阳性的患者, 在影像学引导下进行BMB, 可以提高BMI的检出率。另外, 全身MRI阳性的淋巴瘤BMI患者与全身MRI阴性的淋巴瘤BMI患者相比, 前者预后可能较差。 相似文献
19.
Objective. To determine the correlation between water content and magnetization transfer (MT) ratio of the water component in normal
bone marrow using gradient-echo (GRE) magnetic resonance (MR) imaging.
Design. Three types of GRE sequence – using fat suppression, using a combination of MT and fat suppression techniques, and without
MT or fat suppression – were performed in nine healthy subjects. The water content of bone marrow assessed with GRE imaging
was compared with that assessed with MR spectroscopy in three cases. The correlation between water content and MT ratio was
observed using GRE imaging in nine subjects.
Results and conclusions. The water content as assessed by GRE imaging and by MR spectroscopy were closely correlated (P<0.005, r=0.932). An inverse correlation between water content and MT ratio was observed in normal bone marrow (P<0.03, r=–0.432), which suggests that the water component in bone marrow includes free water protons. 相似文献