MRI gadolinium enhancement of bone marrow: age-related changes in normals and in diffuse neoplastic infiltration |
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Authors: | A. Baur A. Stäbler R. Bartl R. Lamerz J. Scheidler M. Reiser |
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Affiliation: | (1) Department of Diagnostic Radiology, University of Munich (Grosshadern), Marchioninistrasse 15, D-81377 Munich, Germany, DE;(2) Department of Internal Medicine (III), University of Munich (Grosshadern), Marchioninistrasse 15, D-81377 Munich, Germany, DE;(3) Department of Internal Medicine (II), University of Munich (Grosshadern), Marchioninistrasse 15, D-81377 Munich, Germany, DE |
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Abstract: | Objective: To quantify gadolinium-related enhancement in the bone marrow of the spine in normals and in patients with homogeneous diffuse malignant bone marrow infiltration. Design and patients: The patients consisted of two groups: group 1 comprised 94 healthy adults (18–86 years) without bone marrow disease and group 2 comprised 30 patients with homogeneous diffuse malignant bone marrow infiltration due to myeloma (n=20) or breast carcinoma (n=10). All patients received intravenous gadopentetate dimeglumine (Gd-DTPA), 0.1 mmol/kg body weight. Pre- and postcontrast signal intensity (SI) on T1-weighted spin-echo (SE) images (TR/TE: 572 ms/15 ms) was measured over a region of interest (ROI) and the percentage SI increase was calculated. The results were confirmed by bone marrow biopsy (n=20) and clinical parameters (n=10). Dynamic contrast-enhanced studies using a spoiled gradient-recalled-echo (GRE) sequence (TR/TE/α: 68 ms/6 ms 75°) were performed in 10 controls with normal bone marrow. Results and conclusion: Contrast material enhancement in healthy persons can vary greatly (range 3–59%, mean 21%, SD 11%). With increasing age there is a significant decrease in contrast enhancement (Pearson’s correlation, P<0.01). The percentage SI increase in patients with intermediate-grade (biopsy 20–50 vol%) and high-grade (biopsy >50 vol%) diffuse malignant bone marrow infiltration was significantly higher than in normals (mean 67%, SD 34%, P<0.001). Low-grade (biopsy <20 vol%) diffuse malignant bone marrow infiltration can not be assessed by non-enhanced T1-weighted SE images or Gd-DTPA application. In conclusion, contrast material enhancement in healthy persons can vary greatly and is dependent on age, while intermediate-grade and high-grade diffuse malignant bone marrow infiltration can be objectively assessed with SI measurements. |
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Keywords: | Bone marrow MRI Spine Gadopentetate-dimeglumine Diffuse infiltration Contrast enhancement |
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