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Normal Spinal Bone Marrow in Adults: Dynamic Gadolinium-enhanced MR Imaging¹

¹ From the Departments of Radiology (J.L.M., H.K., A.R.), Hematology (M.D.), and Biostatistics (E.L.), Centre Hospitalo-Universitaire Henri Mondor, 51 avenue du Maréchal de Lattre de Tassigny, 94010 Créteil, France; and MR Division, Siemens France, Saint-Denis, France (S.B.). Supported by the Association pour la Recherche contre le Cancer. Received June 18, 2002; revision requested August 20; final revision received March 13, 2003; accepted May 5. Address correspondence to A.R. (e-mail: alain.rahmouni@hmn.ap-hop-paris.fr).

View larger version (71K): [in a new window]   Figure 1a. Sagittal MR images obtained in 15-year-old girl. (a) Precontrast T1-weighted spin-echo image (500/15) shows bone marrow signal intensity similar to that of muscle (grade 1 fat content). (b) T1-weighted spin-echo image (500/15) obtained 4 minutes after bolus injection of gadoterate meglumine shows bone marrow enhancement. On (c) precontrast turbo FLASH image (7/3, 10° flip angle) and (d, e) turbo FLASH images obtained (d) 12 seconds and (e) 42 seconds after enhancement of the aorta with gadoterate meglumine bolus injection, bone marrow enhancement is already evident. Emax reached 430% and occurred 50 seconds after enhancement of the aorta. The regions of interest (circles in c-e) in which measurements were made are shown.

View larger version (77K): [in a new window]   Figure 1b. Sagittal MR images obtained in 15-year-old girl. (a) Precontrast T1-weighted spin-echo image (500/15) shows bone marrow signal intensity similar to that of muscle (grade 1 fat content). (b) T1-weighted spin-echo image (500/15) obtained 4 minutes after bolus injection of gadoterate meglumine shows bone marrow enhancement. On (c) precontrast turbo FLASH image (7/3, 10° flip angle) and (d, e) turbo FLASH images obtained (d) 12 seconds and (e) 42 seconds after enhancement of the aorta with gadoterate meglumine bolus injection, bone marrow enhancement is already evident. Emax reached 430% and occurred 50 seconds after enhancement of the aorta. The regions of interest (circles in c-e) in which measurements were made are shown.

View larger version (65K): [in a new window]   Figure 1c. Sagittal MR images obtained in 15-year-old girl. (a) Precontrast T1-weighted spin-echo image (500/15) shows bone marrow signal intensity similar to that of muscle (grade 1 fat content). (b) T1-weighted spin-echo image (500/15) obtained 4 minutes after bolus injection of gadoterate meglumine shows bone marrow enhancement. On (c) precontrast turbo FLASH image (7/3, 10° flip angle) and (d, e) turbo FLASH images obtained (d) 12 seconds and (e) 42 seconds after enhancement of the aorta with gadoterate meglumine bolus injection, bone marrow enhancement is already evident. Emax reached 430% and occurred 50 seconds after enhancement of the aorta. The regions of interest (circles in c-e) in which measurements were made are shown.

View larger version (67K): [in a new window]   Figure 1d. Sagittal MR images obtained in 15-year-old girl. (a) Precontrast T1-weighted spin-echo image (500/15) shows bone marrow signal intensity similar to that of muscle (grade 1 fat content). (b) T1-weighted spin-echo image (500/15) obtained 4 minutes after bolus injection of gadoterate meglumine shows bone marrow enhancement. On (c) precontrast turbo FLASH image (7/3, 10° flip angle) and (d, e) turbo FLASH images obtained (d) 12 seconds and (e) 42 seconds after enhancement of the aorta with gadoterate meglumine bolus injection, bone marrow enhancement is already evident. Emax reached 430% and occurred 50 seconds after enhancement of the aorta. The regions of interest (circles in c-e) in which measurements were made are shown.

View larger version (69K): [in a new window]   Figure 1e. Sagittal MR images obtained in 15-year-old girl. (a) Precontrast T1-weighted spin-echo image (500/15) shows bone marrow signal intensity similar to that of muscle (grade 1 fat content). (b) T1-weighted spin-echo image (500/15) obtained 4 minutes after bolus injection of gadoterate meglumine shows bone marrow enhancement. On (c) precontrast turbo FLASH image (7/3, 10° flip angle) and (d, e) turbo FLASH images obtained (d) 12 seconds and (e) 42 seconds after enhancement of the aorta with gadoterate meglumine bolus injection, bone marrow enhancement is already evident. Emax reached 430% and occurred 50 seconds after enhancement of the aorta. The regions of interest (circles in c-e) in which measurements were made are shown.

View larger version (88K): [in a new window]   Figure 2a. Sagittal MR images obtained in 57-year-old man. (a) Precontrast T1-weighted spin-echo image (500/15) shows heterogeneous signal intensity with mixed areas of low and high signal intensity (grade 2 fat content). (b) On T1-weighted spin-echo image (500/15) obtained 4 minutes after bolus injection of gadoterate meglumine, bone marrow enhancement is not seen. (c) On precontrast turbo FLASH image (7/3, 10° flip angle) and (d) turbo FLASH image obtained 42 seconds after enhancement of the aorta with gadoterate meglumine injection, bone marrow enhancement (173%) is clearly seen.

View larger version (88K): [in a new window]   Figure 2b. Sagittal MR images obtained in 57-year-old man. (a) Precontrast T1-weighted spin-echo image (500/15) shows heterogeneous signal intensity with mixed areas of low and high signal intensity (grade 2 fat content). (b) On T1-weighted spin-echo image (500/15) obtained 4 minutes after bolus injection of gadoterate meglumine, bone marrow enhancement is not seen. (c) On precontrast turbo FLASH image (7/3, 10° flip angle) and (d) turbo FLASH image obtained 42 seconds after enhancement of the aorta with gadoterate meglumine injection, bone marrow enhancement (173%) is clearly seen.

View larger version (82K): [in a new window]   Figure 2c. Sagittal MR images obtained in 57-year-old man. (a) Precontrast T1-weighted spin-echo image (500/15) shows heterogeneous signal intensity with mixed areas of low and high signal intensity (grade 2 fat content). (b) On T1-weighted spin-echo image (500/15) obtained 4 minutes after bolus injection of gadoterate meglumine, bone marrow enhancement is not seen. (c) On precontrast turbo FLASH image (7/3, 10° flip angle) and (d) turbo FLASH image obtained 42 seconds after enhancement of the aorta with gadoterate meglumine injection, bone marrow enhancement (173%) is clearly seen.

View larger version (77K): [in a new window]   Figure 2d. Sagittal MR images obtained in 57-year-old man. (a) Precontrast T1-weighted spin-echo image (500/15) shows heterogeneous signal intensity with mixed areas of low and high signal intensity (grade 2 fat content). (b) On T1-weighted spin-echo image (500/15) obtained 4 minutes after bolus injection of gadoterate meglumine, bone marrow enhancement is not seen. (c) On precontrast turbo FLASH image (7/3, 10° flip angle) and (d) turbo FLASH image obtained 42 seconds after enhancement of the aorta with gadoterate meglumine injection, bone marrow enhancement (173%) is clearly seen.

View larger version (27K): [in a new window]   Figure 3. Graph illustrates mean ETCs for four different age groups. Bone marrow enhancement decreases markedly with increasing age.

View larger version (17K): [in a new window]   Figure 4. Graph data show that the correlation between Emax and age was significant, with a logarithmic decrease in Emax with increasing age.

View larger version (23K): [in a new window]   Figure 5. Graph data show that Emax decreased as bone marrow fat content increased—from grade 1 to 3—according to qualitative T1-weighted MR signal intensity analysis. However, there was some overlap in Emax values among the three grades of bone marrow fat content.

View larger version (72K): [in a new window]   Figure 6a. Sagittal MR images obtained in 63-year-old man. (a) Precontrast T1-weighted spin-echo image (500/15) shows heterogeneous signal intensity with mixed areas of low and high signal intensity (grade 2 fat content). Note low signal intensity of the L3 and L4 end plates (arrows) due to degenerative changes. (b) On the T1-weighted spin-echo image (500/15) obtained 4 minutes after bolus injection of gadoterate meglumine, bone marrow enhancement is not seen. (c) Precontrast turbo FLASH image (7/3, 10° flip angle) and (d) turbo FLASH image obtained 42 seconds after enhancement of the aorta with gadoterate meglumine show no bone marrow enhancement.

View larger version (71K): [in a new window]   Figure 6b. Sagittal MR images obtained in 63-year-old man. (a) Precontrast T1-weighted spin-echo image (500/15) shows heterogeneous signal intensity with mixed areas of low and high signal intensity (grade 2 fat content). Note low signal intensity of the L3 and L4 end plates (arrows) due to degenerative changes. (b) On the T1-weighted spin-echo image (500/15) obtained 4 minutes after bolus injection of gadoterate meglumine, bone marrow enhancement is not seen. (c) Precontrast turbo FLASH image (7/3, 10° flip angle) and (d) turbo FLASH image obtained 42 seconds after enhancement of the aorta with gadoterate meglumine show no bone marrow enhancement.

View larger version (71K): [in a new window]   Figure 6c. Sagittal MR images obtained in 63-year-old man. (a) Precontrast T1-weighted spin-echo image (500/15) shows heterogeneous signal intensity with mixed areas of low and high signal intensity (grade 2 fat content). Note low signal intensity of the L3 and L4 end plates (arrows) due to degenerative changes. (b) On the T1-weighted spin-echo image (500/15) obtained 4 minutes after bolus injection of gadoterate meglumine, bone marrow enhancement is not seen. (c) Precontrast turbo FLASH image (7/3, 10° flip angle) and (d) turbo FLASH image obtained 42 seconds after enhancement of the aorta with gadoterate meglumine show no bone marrow enhancement.

View larger version (71K): [in a new window]   Figure 6d. Sagittal MR images obtained in 63-year-old man. (a) Precontrast T1-weighted spin-echo image (500/15) shows heterogeneous signal intensity with mixed areas of low and high signal intensity (grade 2 fat content). Note low signal intensity of the L3 and L4 end plates (arrows) due to degenerative changes. (b) On the T1-weighted spin-echo image (500/15) obtained 4 minutes after bolus injection of gadoterate meglumine, bone marrow enhancement is not seen. (c) Precontrast turbo FLASH image (7/3, 10° flip angle) and (d) turbo FLASH image obtained 42 seconds after enhancement of the aorta with gadoterate meglumine show no bone marrow enhancement.