Role of magnetic resonance imaging in the evaluation of bone marrow disorders

To determine the role of Magnetic resonance imaging [MRI] in evaluation of bone marrow disorders. Front 2010 to May 2012, suspected bone marrow lesions were evaluated by MRI in 159 cases [94 males and 65 females]. Bone Marrow pathology included in this study were classified into two groups: malignant and non malignant: 66 patients [41.5%] malignant and 93 patients [58.5%] non-malignant, The 66 patients with malignant group included 33 [50.0%] cases of metastatic disease, 14[21.2%] cases of lymphoma, 10[15.2%] cases of myeloma and 3[4.5%] cases of leukemia. The 93 patients of non-malignant group included 18[19.4%] cases of osteoporotic collapse, 18[19.4%] cases of infectious and inflammatory marrow disorders, 21[22.6] cases of Marrow oedema, 14[15.1%] cases of primary bone tumor, 8[8.6%] cases of marrow reconversion, 10[10.8%] cases of marrow ischemia, 5[5.4%] cases of marrow degenerative disease and 4[4.3%] cases of marrow depletion, myelofibrosis and miscellaneous disorders, MRI is superior to other imaging modalities in evaluating bone marrow because it is remarkably sensitive in detecting lipid, therefore, MRI can be used to detect processes that alter the relative amounts of fat and water in bone marrow. In order to interpret the appearances of marrow seen on MRI and to distinguish normal from abnormal, it is important to understand the normal components and composition of bone marrow, which vary greatly with age and anatomic location within the skeleton. The hone marrow can be affected by infectious, inflammatory, metabolic, and neoplastic processes. Its appearance can he affected as well by underlying degenerative changes, trauma, and numerous iatrogenic therapies, including vertebroplasty, radiation or chemotherapy, and medications designed to stimulate the bone marrow

Spinal nerve roots compression: the superadded diagnostic value of MR myelography

MR provided a new method for generating a myelogram like images of the thecal sac following the conventional MR imaging and based on suppressing background signal using heavily T2 weighted sequences. Forty two degenerative cases were included [group I]in our study [30 cases in the lumbar region, 12 cases in the cervical region and no degenerative cases in the dorsal region]. In addition 38 cases with non-degenerative spinal changes [group II] were included. All cases were examined by conventional multiplanar MRI and MR myelography for detection of the degree of disc prolapse and the compression of the thecal sac and nerve roots. MRI is very specific in determining the etiology of spinal cord compression using the T1,T2 and contrast enhanced sequences. The sensitivity of conventional MRI in the demonstration of the nerve roots compression in our study was 87% in cases with lumbar and cervical disc lesions, 100% in the non degenerative lumbar cases and 87%in non degenerative cervical cases and 75% in dorsal lesions. MR myelography is considered sensitive in 77% of lumbar non degenerative cases, 38% of dorsal non-degenerative cases and 75% in cervical non degenerative cases concerning the detection of the nerve roots compression. MRM allowed a better overall view of the thecal sac and spinal nerve root sleeves making it easier to diagnose spinal canal stenosis and disc herniation. MRM has the advantage of demonstration of the thecal sac and nerve root[s] distal to a complete block. As with conventional myelography, MRM alone can not identify and clearly the cause of nerve root compression and should only be performed as an adjunct to a conventional MR examination