Normal cranial bone marrow MR imaging pattern with age-related ADC value distribution

https://doi.org/10.1016/j.ejrad.2010.09.010Get rights and content

Abstract

Objective

To determine MRI appearances of normal age-related cranial bone marrow and the relationship between MRI patterns and apparent diffusion coefficient (ADC) values.

Methods

Five hundred subjects were divided into seven groups based on ages. Cranial bone marrow MRI patterns were performed based on different thickness of the diploe and signal intensity distribution characteristics. ADC values of the frontal, parietal, occipital and temporal bones on DWI were measured and calculated. Correlations between ages and ADC values, between patterns and ADC values, as well as the distribution of ADC values were analyzed.

Results

Normal cranial bone marrow was divided into four types and six subtypes, Type I, II, III and IV, which had positive correlation with age increasing (χ2 = 266.36, P < 0.01). The ADC values of normal parietal and occipital bone marrow showed significant negative correlation with age growing (r = −0.561 and −0.622, P < 0.01), while there were no significant differences of that with age increasing in frontal and temporal bone marrow (P > 0.05). In addition, there was significant negative correlation between the ADC values and MRI patterns in the normal parietal and occipital bones (r = −0.691 and −0.750, P < 0.01).

Conclusion

The combination of MRI features and ADC values changes in different cranial bones showed significant correlation with age increasing. Familiar with the MRI appearance of the normal bone marrow conversion pattern in different age group and their ADC value will aid the diagnosis and differential of the cranial bone pathology.

Introduction

MR imaging of bone marrow is a very useful non-invasive method to evaluate human age-related normal red and yellow bone marrow distribution pattern and the normal bone marrow conversion patterns from red marrow to yellow marrow. So far, most of the studies were mainly focused on the vertebral body, femur and pelvis [1], [2], [3], [4], [5], [6], [7], [8], [9], [10], [11], [12], [13], [14], [15], [16], [17], [18], [19], [20]. In recent years, the application of MR-DWI in the early diagnosis and differential diagnosis of the benign and malignant lesions in the vertebral body has become one of the hot radiological research subjects [3], [5], [6], [21], [22].

Up to date, there are a few reports on MR imaging studies of the normal cranial bone marrow appearances [23], [24], [25], [26], [27], [28]. To our knowledge, the normal cranial bone marrow MR imaging pattern and the age-related MR-DWI distribution has not been reported. The purpose of this study is to use non-invasive MR imaging method, to evaluate the normal age-related red marrow and yellow marrow distribution and the conversion pattern from the red marrow to yellow marrow within the normal cranial bone. We are trying to establish a MR imaging model for normal cranial bone marrow, including: (1) normal age-related red and yellow marrow MR imaging patterns; (2) normal age-related ADC values distribution. Upon establishment of such a MR diagnostic model for cranial bone marrow, it will be able to evaluate the normal cranial bone marrow in different age groups using non-invasive MR examination. Further more, to be able to make diagnosis and differential diagnosis of the early stage in cranial bone marrow diseases [29], [30], [31].

Section snippets

Materials

Subjects were recruited from patients and healthy volunteers who received head 3.0 T MRI examination in our hospital from January 2006 to August 2009. The inclusion criteria including: (1) normal cranial bone development with no abnormal findings in conventional head MR imaging; (2) normal clinical and follow-up visits, (3) normal laboratory examinations (including blood count and clotting time test) and (4) normal neurological examinations. The exclusion criteria were: (1) history of traumatic

MRI patterns of normal age-related cranial bone marrow

See Table 1 for details.

Correlation between ages and MRI patterns

The thickness of normal cranial diploe gradually increased with aging (Table 1). The distribution of MRI patterns in different age groups was different (Fig. 4). A significant correlation was detected between ages and Type I, II, III and IV (rs = 0.809, P < 0.01) in normal cranial bone marrow by using Spearman's rho, that was normal cranial bone marrow gradually changed from Type I to Type IV with age increasing.

Correlation between ages and ADC values distribution

The ADC values distribution and the tendency of normal

Discussion

Okada et al. [25] first proposed that MRI characteristics of the normal cranial bone marrow were age-related. Ricci et al. [26] suggested a 3-type 3-subtype system to classify the MRI patterns in normal cranial bone marrow based on the conversion pattern, which provides a foundation for the study of cranial bone marrow using MRI.

Our study differs from the above studies in the following ways: (1) application of 3.0 T MR scanner, which enable acquiring of higher SNR [38] and higher quality DW

Conclusions

In conclusion, we demonstrated that MRI features of normal age-related cranial bone marrow change could be an important basis for the analysis of cranial bone marrow imaging. Through combination of conventional MRI with DWI, we established a MRI diagnostic model of normal cranial bone marrow in different age group, which could be beneficial for accurate analysis of the normal development of cranial bone marrow and bone marrow changes during cranial bone diseases. This information is very

Innovation

This study combined 3.0 T MRI and DWI to explore age-related MRI patterns of normal cranial bone marrow in a non-invasive way and established a MR diagnostic model of normal cranial bone marrow, which is favor to assessing the patterns of cranial bone marrow developmental changes at different ages and should be beneficial for the diagnosis and differential diagnosis of cranial bone marrow lesions.

Conflict of interest

There are no conflicts of interest.

Acknowledgement

The authors special thanks to Jingchuan Yang from Philips Company for his contribution to the imaging technique of our study.

References (43)

  • A. Baur et al.

    Diagnostic value of increased diffusion weighting of a steady-state free precession sequence for differentiating acute benign osteoporotic fractures from pathologic vertebral compression fractures

    AJNR Am J Neuroradiol

    (2001)
  • E. Spuentrup et al.

    Diffusion-weighted MR imaging for differentiation of benign fracture edema and tumor infiltration of the vertebral body

    AJR Am J Roentgenol

    (2001)
  • D.A. Finelli

    Diffusion-weighted imaging of acute vertebral compressions: specific diagnosis of benign versus malignant pathologic fractures

    AJNR Am J Neuroradiol

    (2001)
  • A.M. Herneth et al.

    Vertebral metastases: assessment with apparent diffusion coefficient

    Radiology

    (2002)
  • S. Falcone

    Diffusion-weighted imaging in the distinction of benign from metastatic vertebral compression fractures: is this a numbers game

    AJNR Am J Neuroradiol

    (2002)
  • X.J. Zhou et al.

    Characterization of benign and metastatic vertebral compression fractures with quantitative diffusion MR imaging

    AJNR Am J Neuroradiol

    (2002)
  • J.H. Chan et al.

    Acute vertebral body compression fractures: discrimination between benign and malignant causes using apparent diffusion coefficients

    Br J Radiol

    (2002)
  • M. Maeda et al.

    Quantitative assessment of diffusion abnormalities in benign and malignant vertebral compression fractures by line scan diffusion-weighted imaging

    AJR Am J Roentgenol

    (2003)
  • R. Bammer et al.

    Line scan diffusion imaging of the spine

    AJNR Am J Neuroradiol

    (2003)
  • D. Schellinger et al.

    Normal lumbar vertebrae: anatomic, age, and sex variance in subjects at proton MR spectroscopy—initial experience

    Radiology

    (2000)
  • H. Kugel et al.

    Age- and sex-specific differences in the 1H-spectrum of vertebral bone marrow

    J Magn Reson Imaging

    (2001)
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