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Skeletal Radiology

, Volume 45, Issue 9, pp 1205–1212 | Cite as

Utilization of chemical shift MRI in the diagnosis of disorders affecting pediatric bone marrow

Scientific Article

Abstract

Objective

MRI signal intensity of pediatric bone marrow can be difficult to interpret using conventional methods. Chemical shift imaging (CSI), which can quantitatively assess relative fat content, may improve the ability to accurately diagnose bone marrow abnormalities in children.

Methods

Consecutive pelvis and extremity MRI at a children’s hospital over three months were retrospectively reviewed for inclusion of CSI. Medical records were reviewed for final pathological and/or clinical diagnosis. Cases were classified as normal or abnormal, and if abnormal, subclassified as marrow-replacing or non-marrow-replacing entities. Regions of interest (ROI) were then drawn on corresponding in and out-of-phase sequences over the marrow abnormality or over a metaphysis and epiphysis in normal studies. Relative signal intensity ratio for each case was then calculated to determine the degree of fat content in the ROI.

Results

In all, 241 MRI were reviewed and 105 met inclusion criteria. Of these, 61 had normal marrow, 37 had non-marrow-replacing entities (osteomyelitis without abscess n = 17, trauma n = 9, bone infarction n = 8, inflammatory arthropathy n = 3), and 7 had marrow-replacing entities (malignant neoplasm n = 4, bone cyst n = 1, fibrous dysplasia n = 1, and Langerhans cell histiocytosis n = 1). RSIR averages were: normal metaphyseal marrow 0.442 (0.352–0.533), normal epiphyseal marrow 0.632 (0.566–698), non-marrow-replacing diagnoses 0.715 (0.630–0.799), and marrow-replacing diagnoses 1.06 (0.867–1.26). RSIR for marrow-replacing entities proved significantly different from all other groups (p < 0.05). ROC analysis demonstrated an AUC of 0.89 for RSIR in distinguishing marrow-replacing entities.

Conclusion

CSI techniques can help to differentiate pathologic processes that replace marrow in children from those that do not.

Keywords

Chemical shift imaging Bone marrow Magnetic resonance imaging 

Notes

Compliance with ethical standards

Conflict of Interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was waived due to the retrospective nature of the study.

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Copyright information

© ISS 2016

Authors and Affiliations

  • Matthew Winfeld
    • 1
  • Shivani Ahlawat
    • 2
  • Nabile Safdar
    • 3
  1. 1.University of Pennsylvania Perelman School of MedicinePhiladelphiaUSA
  2. 2.The Russell H. Morgan Department of Radiology and Radiological ScienceThe Johns Hopkins Medical InstitutionsBaltimoreUSA
  3. 3.Department of Radiology and Imaging SciencesEmory University School of MedicineAtlantaUSA

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