Shivani Gogi1 , Veena Madireddy2 , Vanaja Bulkapuram3 , Vijaya Kumari Mudunuri4
BACKGROUND MRI is a very sensitive technique for evaluating bone marrow as it differentiates normal from pathological marrow and displays changes at the cellular level. It is a useful technique for noninvasive evaluation of pathological bone marrow conditions. MRI serves as a screening method in bone marrow disorders and diagnosis can be established in context with clinical findings or by biopsy. We wanted to study the different imaging features of bone marrow disorders on MRI, correlate MRI imaging with plain radiograph, and correlate MRI imaging and radiographic features with clinical history. METHODS 110 patients referred from various departments with skeletal ailments were subjected to study under 1.5 T Siemens Avanto Machine using T1, T2, STIR and contrast procedure was done in indicated subjects. RESULTS During the study period of eighteen months, MRI showed bone marrow changes in 110 cases with exclusion of trauma, haemangiomas and degenerative changes. MRI was confirmatory in majority of cases and no additional invasive investigations or otherwise required. Tubercular spondylitis accounted for the majority of cases in our study. Most of the lesions with diffuse involvement were benign and most of the malignant lesions showed focal involvement. Contrast enhancement was noted in both inflammatory and malignant cases although intense enhancement was noted in malignant cases. Bone marrow biopsy was done in 20 cases which were suspected as malignant in MRI but only 14 of them proved to be malignant. Differentiation between renal osteodystrophy and fluorosis is difficult based on MRI findings alone but integrating with clinical history, plain radiograph for ligament ossification, and serum creatinine levels were helpful in accurate diagnosis. CONCLUSIONS Appearance of MRI signal in various sequences with age correlation is essential in identification and interpretation of various pathologies. MRI is found to be more sensitive in detecting diffuse and focal bone marrow pathology.
