"Marrow infiltration" and "marrow replacement" refer to amount of cellular vs. adipocytes admixed in lesion
Diffuse marrow infiltration: moderately cellular tissue admixed with fat with diffuse bone involvement
Regenerated/repopulated/stimulated red marrow
Chronic infection
HIV/AIDS
Storage disorders
Early (or treated) phase of myelodysplasia and myeloproliferative disorders
Diffuse marrow replacement: densely cellular lesions with no significant adipocytes, distributed diffusely in skeleton
Bone metastases
Erdheim-Chester disease
Multiple myeloma
Myelodysplasias: diverse group of hematologic conditions due to ineffective production of myeloid elements
Characterized by variety of refractory anemic conditions
Myeloproliferative disorders: overproduction of myeloid elements
Platelets (essential thrombocytosis)
Reticulocytes (polycythemia vera)
Fibroblasts/collagen (myelofibrosis)
White cells (leukemia)
Diffuse marrow infiltration or replacement does not connote benignity or malignancy per se
IMAGING
General Features
Radiographic Findings
CT Findings
MR Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
Staging, Grading, & Classification
Gross Pathologic & Surgical Features
CLINICAL ISSUES
Presentation
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Image Interpretation Pearls
Reporting Tips
Selected References
Colombo A et al: Effects of sex and age on fat fraction, diffusion-weighted image signal intensity and apparent diffusion coefficient in the bone marrow of asymptomatic individuals: a cross-sectional whole-body MRI study. Diagnostics (Basel). 11(5), 2021
van Vucht N et al: Anomalous signal intensity increase on out-of-phase chemical shift imaging: a manifestation of marrow mineralisation? Skeletal Radiol. 49(8):1269-75, 2020
Degnan AJ et al: Imaging of non-neuronopathic Gaucher disease: recent advances in quantitative imaging and comprehensive assessment of disease involvement. Insights Imaging. 10(1):70, 2019
Messiou C et al: Guidelines for acquisition, interpretation, and reporting of whole-body MRI in myeloma: myeloma response assessment and diagnosis system (MY-RADS). Radiology. 291(1):5-3, 2019
van Vucht N et al: The Dixon technique for MRI of the bone marrow. Skeletal Radiol. 48(12):1861-74, 2019
Kumar NM et al: Chemical shift imaging with in-phase and opposed-phase sequences at 3 T: what is the optimal threshold, measurement method, and diagnostic accuracy for characterizing marrow signal abnormalities? Skeletal Radiol. 47(12):1661-71, 2018
Young JR et al: 18F-FDG PET/CT in Erdheim-Chester disease: imaging findings and potential BRAF mutation biomarker. J Nucl Med. 59(5):774-79, 2018
Douis H et al: Chemical shift MRI can aid in the diagnosis of indeterminate skeletal lesions of the spine. Eur Radiol. 26(4):932-40, 2016
Laudemann K et al: Evaluation of bone marrow infiltration in non-neuropathic gaucher disease patients with use of whole-body MRI - a retrospective data analysis. Rofo. 187(12):1093-8, 2015
Kohl CA et al: Accuracy of chemical shift MR imaging in diagnosing indeterminate bone marrow lesions in the pelvis: review of a single institution's experience. Skeletal Radiol. 43(8):1079-84, 2014
Padhani AR et al: Assessing the relation between bone marrow signal intensity and apparent diffusion coefficient in diffusion-weighted MRI. AJR Am J Roentgenol. 200(1):163-70, 2013
Moore SL et al: Can sarcoidosis and metastatic bone lesions be reliably differentiated on routine MRI? AJR Am J Roentgenol. 198(6):1387-93, 2012
Kung JW et al: Bone marrow signal alteration in the extremities. AJR Am J Roentgenol. 196(5):W492-510, 2011
Kan JH et al: MRI diagnosis of bone marrow relapse in children with ALL. Pediatr Radiol. 38(1):76-81, 2008
Vande Berg, BC: General principles of magnetic resonance imaging of the bone marrow. In Pope T et al: Imaging of the Musculoskeletal System. 1st ed. Elsevier. 1417-30, 2008
Steinbach LS: "MRI in the detection of malignant infiltration of bone marrow"--a commentary. AJR Am J Roentgenol. 188(6):1443-5, 2007
Tang YM et al: MRI features of bone marrow necrosis. AJR Am J Roentgenol. 188(2):509-14, 2007
Dion E et al: Bone involvement in Erdheim-Chester disease: imaging findings including periostitis and partial epiphyseal involvement. Radiology. 238(2):632-9, 2006
Moore SL et al: MRI of sarcoidosis patients with musculoskeletal symptoms. AJR Am J Roentgenol. 185(1):154-9, 2005
Zajick DC Jr et al: Benign and malignant processes: normal values and differentiation with chemical shift MR imaging in vertebral marrow. Radiology. 237(2):590-6, 2005
Maas M et al: Quantification of bone involvement in Gaucher disease: MR imaging bone marrow burden score as an alternative to Dixon quantitative chemical shift MR imaging--initial experience. Radiology. 229(2):554-61, 2003
Moore SL et al: Musculoskeletal sarcoidosis: spectrum of appearances at MR imaging. Radiographics. 23(6):1389-99, 2003
Lecouvet FE et al: Magnetic resonance and computed tomography imaging in multiple myeloma. Semin Musculoskelet Radiol. 5(1):43-55, 2001
Walker RE et al: Whole-body magnetic resonance imaging: techniques, clinical indications, and future applications. Semin Musculoskelet Radiol. 5(1):5-20, 2001
Panicek DM et al: MR imaging of bone Marrow in patients with musculoskeletal tumors. Sarcoma. 3(1):37-41, 1999
Vande Berg BC et al: Classification and detection of bone marrow lesions with magnetic resonance imaging. Skeletal Radiol. 27(10):529-45, 1998
Vanel D et al: MRI of bone metastases. Eur Radiol. 8(8):1345-51, 1998
Wismer GL et al: Chemical shift imaging of bone marrow: preliminary experience. AJR Am J Roentgenol. 145(5):1031-7, 1985
Related Anatomy
Loading...
Related Differential Diagnoses
Loading...
References
Tables
Tables
KEY FACTS
Terminology
Imaging
TERMINOLOGY
Synonyms
Myelodysplasia: formerly known as preleukemia
Definitions
"Marrow infiltration" and "marrow replacement" refer to amount of cellular vs. adipocytes admixed in lesion
Diffuse marrow infiltration: moderately cellular tissue admixed with fat with diffuse bone involvement
Regenerated/repopulated/stimulated red marrow
Chronic infection
HIV/AIDS
Storage disorders
Early (or treated) phase of myelodysplasia and myeloproliferative disorders
Diffuse marrow replacement: densely cellular lesions with no significant adipocytes, distributed diffusely in skeleton
Bone metastases
Erdheim-Chester disease
Multiple myeloma
Myelodysplasias: diverse group of hematologic conditions due to ineffective production of myeloid elements
Characterized by variety of refractory anemic conditions
Myeloproliferative disorders: overproduction of myeloid elements
Platelets (essential thrombocytosis)
Reticulocytes (polycythemia vera)
Fibroblasts/collagen (myelofibrosis)
White cells (leukemia)
Diffuse marrow infiltration or replacement does not connote benignity or malignancy per se
IMAGING
General Features
Radiographic Findings
CT Findings
MR Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
Staging, Grading, & Classification
Gross Pathologic & Surgical Features
CLINICAL ISSUES
Presentation
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Image Interpretation Pearls
Reporting Tips
Selected References
Colombo A et al: Effects of sex and age on fat fraction, diffusion-weighted image signal intensity and apparent diffusion coefficient in the bone marrow of asymptomatic individuals: a cross-sectional whole-body MRI study. Diagnostics (Basel). 11(5), 2021
van Vucht N et al: Anomalous signal intensity increase on out-of-phase chemical shift imaging: a manifestation of marrow mineralisation? Skeletal Radiol. 49(8):1269-75, 2020
Degnan AJ et al: Imaging of non-neuronopathic Gaucher disease: recent advances in quantitative imaging and comprehensive assessment of disease involvement. Insights Imaging. 10(1):70, 2019
Messiou C et al: Guidelines for acquisition, interpretation, and reporting of whole-body MRI in myeloma: myeloma response assessment and diagnosis system (MY-RADS). Radiology. 291(1):5-3, 2019
van Vucht N et al: The Dixon technique for MRI of the bone marrow. Skeletal Radiol. 48(12):1861-74, 2019
Kumar NM et al: Chemical shift imaging with in-phase and opposed-phase sequences at 3 T: what is the optimal threshold, measurement method, and diagnostic accuracy for characterizing marrow signal abnormalities? Skeletal Radiol. 47(12):1661-71, 2018
Young JR et al: 18F-FDG PET/CT in Erdheim-Chester disease: imaging findings and potential BRAF mutation biomarker. J Nucl Med. 59(5):774-79, 2018
Douis H et al: Chemical shift MRI can aid in the diagnosis of indeterminate skeletal lesions of the spine. Eur Radiol. 26(4):932-40, 2016
Laudemann K et al: Evaluation of bone marrow infiltration in non-neuropathic gaucher disease patients with use of whole-body MRI - a retrospective data analysis. Rofo. 187(12):1093-8, 2015
Kohl CA et al: Accuracy of chemical shift MR imaging in diagnosing indeterminate bone marrow lesions in the pelvis: review of a single institution's experience. Skeletal Radiol. 43(8):1079-84, 2014
Padhani AR et al: Assessing the relation between bone marrow signal intensity and apparent diffusion coefficient in diffusion-weighted MRI. AJR Am J Roentgenol. 200(1):163-70, 2013
Moore SL et al: Can sarcoidosis and metastatic bone lesions be reliably differentiated on routine MRI? AJR Am J Roentgenol. 198(6):1387-93, 2012
Kung JW et al: Bone marrow signal alteration in the extremities. AJR Am J Roentgenol. 196(5):W492-510, 2011
Kan JH et al: MRI diagnosis of bone marrow relapse in children with ALL. Pediatr Radiol. 38(1):76-81, 2008
Vande Berg, BC: General principles of magnetic resonance imaging of the bone marrow. In Pope T et al: Imaging of the Musculoskeletal System. 1st ed. Elsevier. 1417-30, 2008
Steinbach LS: "MRI in the detection of malignant infiltration of bone marrow"--a commentary. AJR Am J Roentgenol. 188(6):1443-5, 2007
Tang YM et al: MRI features of bone marrow necrosis. AJR Am J Roentgenol. 188(2):509-14, 2007
Dion E et al: Bone involvement in Erdheim-Chester disease: imaging findings including periostitis and partial epiphyseal involvement. Radiology. 238(2):632-9, 2006
Moore SL et al: MRI of sarcoidosis patients with musculoskeletal symptoms. AJR Am J Roentgenol. 185(1):154-9, 2005
Zajick DC Jr et al: Benign and malignant processes: normal values and differentiation with chemical shift MR imaging in vertebral marrow. Radiology. 237(2):590-6, 2005
Maas M et al: Quantification of bone involvement in Gaucher disease: MR imaging bone marrow burden score as an alternative to Dixon quantitative chemical shift MR imaging--initial experience. Radiology. 229(2):554-61, 2003
Moore SL et al: Musculoskeletal sarcoidosis: spectrum of appearances at MR imaging. Radiographics. 23(6):1389-99, 2003
Lecouvet FE et al: Magnetic resonance and computed tomography imaging in multiple myeloma. Semin Musculoskelet Radiol. 5(1):43-55, 2001
Walker RE et al: Whole-body magnetic resonance imaging: techniques, clinical indications, and future applications. Semin Musculoskelet Radiol. 5(1):5-20, 2001
Panicek DM et al: MR imaging of bone Marrow in patients with musculoskeletal tumors. Sarcoma. 3(1):37-41, 1999
Vande Berg BC et al: Classification and detection of bone marrow lesions with magnetic resonance imaging. Skeletal Radiol. 27(10):529-45, 1998
Vanel D et al: MRI of bone metastases. Eur Radiol. 8(8):1345-51, 1998
Wismer GL et al: Chemical shift imaging of bone marrow: preliminary experience. AJR Am J Roentgenol. 145(5):1031-7, 1985
STATdx includes over 200,000 searchable images, including x-ray, CT, MR, and ultrasound images. To access all images, please log in or subscribe.