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Advanced MR imaging of bone marrow: quantification of signal alterations on T1-weighted Dixon and T2-weighted Dixon sequences in red marrow, yellow marrow, and pathologic marrow lesions

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Abstract

Objectives

To quantify and compare signal intensity (SI) changes on T1-weighted (W) and T2W Dixon imaging in yellow marrow, red marrow, and bone marrow lesions.

Materials and methods

A total of 141 patients (77 controls, 64 lesions—33 benign, 31 malignant) between January 2016 and December 2017 were retrospectively identified. For the control group, fixed 2-cm2 region of interests (ROI) were drawn at L5, bilateral ilium and femurs on in-phase and opposed-phase T1W and T2W Dixon images. For the lesion group, ROIs of best fit were drawn around each lesion on in-phase and opposed-phase T2W Dixon images. SI changes between in-phase and opposed phase maps for each group were compared. Inter-reader analysis was performed.

Results

Yellow marrow exhibited smaller SI changes as compared to red marrow on both T1W and T2W Dixon imaging at all locations (p < 0.0001) except at L5 on T2W Dixon imaging (p = 0.206). Both benign and malignant lesions showed significantly smaller SI changes as compared to both yellow (p = 0.0087, p < 0.0001) and red marrow (p = 0.0004, p < 0.0001) on T2W Dixon imaging. Malignant lesions exhibited smaller SI change as compared to benign lesions on T2W Dixon imaging (p = 0.0005). Signal intensity loss on both red and yellow marrow were smaller on T1W Dixon as compared to T2W Dixon (0.49–0.64, 0.27–0.31 vs. 0.70–0.74, 0.48–0.71). Inter-reader agreements were excellent (0.91–0.97).

Conclusions

SI change calculated from T2-weighted Dixon imaging can adequately differentiate between yellow marrow, red marrow, and osseous lesions, both benign and malignant.

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Abbreviations

CHESS:

Chemical shift-selective fat saturation

CSI:

Chemical shift imaging

ROI:

Region of interest

SI:

Signal intensity

SD:

Standard deviation

STIR:

Short inversion time inversion-recovery

W:

Weighted

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Authors and Affiliations

  1. Radiology Department, UT Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX, 75390, USA

    Chayanit Sasiponganan, Kevin Yan, Parham Pezeshk, Yin Xi & Avneesh Chhabra

  2. Orthopedics Department, UT Southwestern Medical Center, Dallas, TX, USA

    Avneesh Chhabra

Authors
  1. Chayanit Sasiponganan
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  2. Kevin Yan
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  3. Parham Pezeshk
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  4. Yin Xi
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  5. Avneesh Chhabra
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Correspondence to Chayanit Sasiponganan.

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Sasiponganan, C., Yan, K., Pezeshk, P. et al. Advanced MR imaging of bone marrow: quantification of signal alterations on T1-weighted Dixon and T2-weighted Dixon sequences in red marrow, yellow marrow, and pathologic marrow lesions. Skeletal Radiol 49, 541–548 (2020). https://doi.org/10.1007/s00256-019-03303-z

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  • DOI: https://doi.org/10.1007/s00256-019-03303-z

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