Advanced

AJNR - American Journal of Neuroradiology

This Article Figures Only Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Loevner, L. A. Articles by Hsu, W. C. Search for Related Content PubMed PubMed Citation Articles by Loevner, L. A. Articles by Hsu, W. C.

American Journal of Neuroradiology 23:248-254, February 2002
© 2002 American Society of Neuroradiology

BRAIN

MR Imaging Characteristics of Cranial Bone Marrow in Adult Patients with Underlying Systemic Disorders Compared with Healthy Control Subjects

Laurie A. Loevner^a, Jennifer D. Tobey^b, David M. Yousem^a, Adina I. Sonners^c and Wendy C. Hsu^a

^a Department of Radiology, University of Pennsylvania Medical Center, PA
^b University of Pennsylvania Medical Center, PA
^c Robert Wood Johnson Medical School, Camden, NJ

Address reprint requests to Laurie A. Loevner, MD, Department of Radiology, University of Pennsylvania Medical Center, 3400 Spruce Street, Philadelphia, PA 19104

BACKGROUND AND PURPOSE: In young adults, hematopoietic bone marrow has usually converted to fatty marrow. Fat hyperintensity on T1-weighted MR images facilitates the evaluation of marrow abnormalities. Our purpose was to compare cranial marrow signal intensity patterns in adults with systemic disorders and in healthy subjects.

METHODS: MR images in 25 adults with underlying systemic disorders (chronic anemia, lymphoma, leukemia, or other infiltrative processes) and 44 healthy aged-matched individuals were retrospectively reviewed. Calvarial and clival marrow signal intensity on sagittal T1-weighted images was graded relative to that of orbital fat, white matter (WM), and gray matter (GM). Marrow was classified as homogeneous (uniformly isointense), diffusely heterogeneous (mottled), or focally heterogeneous (generally isointense with a focal lesion).

RESULTS: In 84% of the control subjects, bone marrow was iso- or hyperintense relative to WM. Patients had abnormal diploic (n = 22) or clival (n = 17) marrow; 22 had calvarial marrow that was hypointense relative to WM compared with that in seven healthy subjects (P < .001). Marrow hypointensity relative to WM was a sensitive (93%) and specific (86%) marker of pathologic abnormality. Although marrow hypointensity relative to GM was specific (96%), it was not sensitive (67%). Calvarial and clival marrow patterns, respectively, were homogeneous in 81% and 64% of control subjects and 76% and 60% of patients. Clival marrow intensity varied more than did calvarial intensity; therefore, clival criteria were less sensitive and accurate in systemic disease detection.

CONCLUSION: Homogeneous diploic marrow hypointense relative to WM on non-contrast-enhanced T1-weighted images suggests an underlying systemic or hematologic disorder and requires appropriate clinical correlation and evaluation.

This article has been cited by other articles:

				D.M. Yousem, K. Gad, and R.P. Tufano Resectability Issues with Head and Neck Cancer AJNR Am. J. Neuroradiol., November 1, 2006; 27(10): 2024 - 2036. [Abstract] [Full Text] [PDF]