MRI of the Abnormal Bone Marrow: Diffuse Pattern
A diffuse MRI pattern is not common with bone metastases. The abnormal bone marrow is hypo- or isointense to the intervertebral discs or to muscle on T1-weighted images, quite similar to diffuse bone marrow patterns of other etiologies (Fig. 6.1). Rarely, widespread osteoblastic metastatic disease may present as very hypointense (signal void) diffuse pattern (Fig. 6.2). The signal intensity of the abnormal marrow is more often heterogeneous. If the metastases are limited to the bone marrow with little or no trabecular destruction, skeletal scintigraphy and CT may be negative. Bone metastases from small round cell tumors such as neuroblastoma, Ewing’s sarcoma, rhabdomyosarcoma, and small cell lung cancer and carcinoid are the ones most often associated with a diffuse MRI pattern (Fig. 6.3). This is attributed to the permeative nature of these tumors which diffusely infiltrate the marrow without significant alteration of the bony architecture.
KeywordsMultiple Myeloma Acute Lymphocytic Leukemia Chronic Lymphocytic Leukemia Intervertebral Disc Hodgkin Lymphoma
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