title: Bone marrow enhancement during time-resolved magnetic resonance angiography of the pelvis.
abstract: OBJECTIVE
  This study aimed to determine whether visible bone marrow enhancement (BME) at pelvic magnetic resonance angiography (MRA) correlates with anemia.
  
  
  METHODS
  This is an institutional review board-approved, Health Insurance Portability and Accountability Act-compliant retrospective study. Seventy-five female patients with a hemoglobin (Hb) test within 10 days of an MRA examination of the pelvis are included, mean age of 46 years (range, 18-81 years). The BME was graded using a 4-point scale. Fifteen subjects had sufficient imaging data for calculation of quantitative perfusion parameters. Receiver operating characteristic and analysis of covariance were performed for 2 levels of anemia.
  
  
  RESULTS
  Enhancement was visually present in 44% (33/75) of cases; 66% (19/29) of anemic subjects (Hb < 12 g/dL), and 30% (14/46) of nonanemic subjects (P = 0.002). Enhancement had a sensitivity of 87.5% and a specificity of 92.5% for the diagnosis of severe anemia (Hb < 10 g/dL); 88% (7/8) of these subjects had moderate to marked enhancement. A high extraction coefficient (Kep) in the iliac crest was associated with anemia, with an area under the curve of the receiver operating characteristic of 0.85 for mild anemia and 0.92 for severe anemia.
  
  
  CONCLUSIONS
  Visible BME during time-resolved MRA is common and may be related to anemia.
authors.affiliation: Department of Radiology, Wake Forest Baptist Medical Center, Winston Salem, NC 27157, USA. bcallen2@wakehealth.edu
authors.forename: Brian C
authors.initials: BC
authors.lastname: Allen
authors.forename: Mustafa R
authors.initials: MR
authors.lastname: Bashir
authors.forename: Brian M
authors.initials: BM
authors.lastname: Dale
authors.forename: Tobias J
authors.initials: TJ
authors.lastname: Heye
authors.forename: Rajan T
authors.initials: RT
authors.lastname: Gupta
authors.forename: Elmar M
authors.initials: EM
authors.lastname: Merkle
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D000740:Anemia / Q000473:pathology*; D001853:Bone Marrow / Q000473:pathology*; D003287:Contrast Media; D005260:Female; D006801:Humans; D018810:Magnetic Resonance Angiography / Q000379:methods*; D008536:Meglumine / Q000031:analogs & derivatives; D008875:Middle Aged; D009942:Organometallic Compounds; D010388:Pelvis; D012372:ROC Curve; D012189:Retrospective Studies
chemical_list: D003287:Contrast Media; D009942:Organometallic Compounds; C064572:gadobenic acid; D008536:Meglumine