title: Perfusion parameters analysis of the vertebral bone marrow in patients with Ph¹⁻ chronic myeloproliferative neoplasms (Ph(neg) MPN): a dynamic contrast-enhanced MRI (DCE-MRI) study.
abstract: OBJECTIVE
  To evaluate perfusion parameters of the vertebral bone marrow in patients with Philadelphia negative chronic myeloproliferative neoplasms (Ph(neg) MPN) using dynamic contrast-enhanced MRI (DCE-MRI).
  
  
  METHODS
  The study enrolled 24 patients with Ph(neg) MPN: 12 patients with myelofibrosis (Group A), 6 with essential thrombocythemia (ET), and 6 with polycythemia vera (PV) (Group B) who underwent DCE-MRI of the lumbosacral spine. Twelve normal individuals served as control group (Group C). Wash-in (WIN), wash-out (WOUT), maximum contrast-enhancement (CE  max), time-to-peak (TTPK), time-to-maximum slope (TMSP), and the WIN/TMSP ratio (WTSP) were calculated.
  
  
  RESULTS
  WIN, CE(max) , and WTSP parameters were higher in Group A than in Group C (P < 0.05). These parameters were significant (P < 0.0001) in discriminating patients with myelofibrosis from normal individuals with sensitivities 74.14%, 87.93%, 74.14%, and specificities 91.07%, 83.93%, 91.07%, respectively. WIN, WOUT, CE(max) , and WTSP parameters were higher in Group A than in Group B (P < 0.05). Group B exhibited no differences in perfusion parameters as compared with Group C with the exception of WOUT.
  
  
  CONCLUSIONS
  Patients with myelofibrosis exhibited increased perfusion parameters in vertebral bone marrow, which could be consisted with increased vascularity, probably related to neoangiogenesis as opposed to ET or PV patients showing no increased perfusion. DCE-MRI may be of value in discriminating subgroups of Ph(neg) MPN patients and in indicating those progressing to myelofibrosis.
authors: Department of Radiology and Medical Imaging, Medical School, Democritus University of Thrace, Greece. ncourcou@med.duth.gr
authors: Nikos
authors: N
authors: Courcoutsakis
authors: Athina
authors: A
authors: Spanoudaki
authors: Thomas G
authors: TG
authors: Maris
authors: Emmanuel
authors: E
authors: Astrinakis
authors: Emmanuel
authors: E
authors: Spanoudakis
authors: Constantinos
authors: C
authors: Tsatalas
authors: Panos
authors: P
authors: Prassopoulos
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D001853:Bone Marrow / Q000473:pathology*; D019046:Bone Marrow Neoplasms / Q000473:pathology*; D016022:Case-Control Studies; D003287:Contrast Media; D005260:Female; D006801:Humans; D008161:Lumbosacral Region; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008833:Microcirculation; D008875:Middle Aged; D009389:Neovascularization, Pathologic / Q000473:pathology*; D009942:Organometallic Compounds; D011087:Polycythemia Vera / Q000473:pathology*; D011237:Predictive Value of Tests; D055728:Primary Myelofibrosis / Q000473:pathology*; D012372:ROC Curve; D012680:Sensitivity and Specificity
chemical_list: D003287:Contrast Media; D009942:Organometallic Compounds; C090600:gadobutrol