[Magnetic resonance imaging and spectroscopy of the bone marrow in children with common hematological diseases].
OBJECTIVE
To evaluate the magnetic resonance (MR) imaging and proton magnetic resonance spectroscopy ((1)H-MRS) in the diagnoses of pediatric hematological diseases.


METHODS
A total of 35 cases with pediatric hematological diseases were confirmed by bone marrow puncturing. There were acute leukemia (n = 26), aplastic anemia (n = 6), thalassemia (n = 2) and autoimmune hemolytic anemia (n = 1). Thirty age-marched healthy children underwent MR imaging (T(1)WI, T(2)WI, STIR) and (1)H-MRS of lumber spine and ilium. The lumber spines and iliums were studied by observation of MR imaging and calculation of fat fraction (FF%).


RESULTS
Two patterns were classified by MR imaging and (1)H-MRS in lumber spines and iliums of all cases. Pattern 1: hyperplasia of bone marrow (BM). There were acute leukemia (n = 26), thalassemia (n = 2) and autoimmune hemolytic anemia (n = 1). The manifestations included homogeneous low signal intensity (SI) on T(1)WI, homogeneous low SI on T(2)WI, high SI on STIR and high water peak and low fat peak on (1)H-MRS. The FF%s of Regions of Interest (ROI) in lumber 4s and left iliums of 26 cases with acute leukemia were 0%, of 3 cases with thalassemia or autoimmune hemolytic anemia were 5.02% and 3.70%. Pattern 2: inhibition of BM. There were 6 cases of aplastic anemia. The manifestations included homogeneous or inhomogeneous high SI on T(1)WI and T(2)WI, homogeneous or inhomogeneous low SI on STIR, and low water peak and high fat peak on (1)H-MRS. FF%s of ROI in lumber 4s and left iliums for 6 cases of aplastic anemia were 74.69% and 91.51%. FF% in all groups had significant differences according to the Mann-Whitney test (P < 0.05).


CONCLUSIONS
MR imaging and (1)H-MRS may serve as a noninvasive method for checking hematopoietic status of bone marrow in pediatric hematological diseases.
Department of Radiology, Second Affiliated Hospital, Wenhou Medical College, Wenhou 325000, China.
Li
L
Xu
Yu
Y
Chen
Jia-wei
JW
He
Zhi-han
ZH
Yan
Xin-jian
XJ
Ye
Guang-hui
GH
Bai
Xian
X
Zhang
Zhi-kang
ZK
Yu
D000293:Adolescent; D000741:Anemia, Aplastic / Q000175:diagnosis / Q000473:pathology / Q000503:physiopathology; D001853:Bone Marrow / Q000473:pathology* / Q000503:physiopathology; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D005260:Female; D006402:Hematologic Diseases / Q000175:diagnosis* / Q000473:pathology* / Q000503:physiopathology; D006801:Humans; D007938:Leukemia / Q000175:diagnosis / Q000473:pathology / Q000503:physiopathology; D008279:Magnetic Resonance Imaging; D009682:Magnetic Resonance Spectroscopy; D008297:Male; D009190:Myelodysplastic Syndromes / Q000175:diagnosis / Q000473:pathology / Q000503:physiopathology