title: MRI gadolinium enhancement of bone marrow: age-related changes in normals and in diffuse neoplastic infiltration.
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.
  
  
  METHODS
  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/alpha: 68 ms/6 ms 75 degrees) were performed in 10 controls with normal bone marrow.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Diagnostic Radiology, University of Munich (Grosshadern), Germany.
authors.forename: A
authors.initials: A
authors.lastname: Baur
authors.forename: A
authors.initials: A
authors.lastname: Stäbler
authors.forename: R
authors.initials: R
authors.lastname: Bartl
authors.forename: R
authors.initials: R
authors.lastname: Lamerz
authors.forename: J
authors.initials: J
authors.lastname: Scheidler
authors.forename: M
authors.initials: M
authors.lastname: Reiser
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000473:pathology*; D001853:Bone Marrow / Q000473:pathology*; D019046:Bone Marrow Neoplasms / Q000473:pathology* / Q000556:secondary*; D001943:Breast Neoplasms / Q000473:pathology; D003287:Contrast Media; D005260:Female; D005682:Gadolinium; D019786:Gadolinium DTPA; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000473:pathology; D009942:Organometallic Compounds; D004369:Pentetic Acid / Q000031:analogs & derivatives*
chemical_list: D003287:Contrast Media; D009942:Organometallic Compounds; D004369:Pentetic Acid; D005682:Gadolinium; D019786:Gadolinium DTPA