Polycythemia vera and myelofibrosis: correlation of MR imaging, clinical, and laboratory findings.

Abstract

Magnetic resonance (MR) imaging was performed in 14 patients with biopsy-proved polycythemia vera (n = 4) or myelofibrosis (n = 10) to determine whether MR imaging findings can be correlated with the clinicopathologic diagnosis and established clinical parameters of severity (serum lactate dehydrogenase [LDH] and cholesterol levels) and chronicity (spleen size). Evaluation of marrow in the proximal femurs showed that patients could be categorized into three distinct groups based on anatomic patterns of normal fatty and abnormal low-signal-intensity (non-fatty) marrow in the femoral capital epiphysis (FCE) and greater trochanter (GT). Patients with nonfatty marrow in both the FCE and GT (n = 8) had significantly higher serum LDH (P less than .02) and lower serum cholesterol (P less than .02) levels than patients with fatty marrow in at least the GT (n = 6). Splenic volume, as measured from MR images, was significantly greater in the myelofibrosis group than in the polycythemia vera group (P less than .001). MR imaging provided a better understanding of these hematologic disorders and novel parameters for classification that are different from conventional histologic and laboratory data.

Distinguishing Imaging Features between Spinal Hyperplastic Hematopoietic Bone Marrow and Bone Metastasis

“…Because heavy smoking and chronic anemia can lead to HHBM, 5-9 their history of smoking and anemia may have affected the etiology of HHBM in our patients. Second, we did not use other imaging techniques for differentiating HHBM from bone metastasis, such as MR imaging with in-phase and opposed-phase techniques 15 or contrast-enhanced MR imaging by using iron oxide. 16 Third, the tumor type of bone metastasis may have affected our results.…”

Magnetic Resonance Imaging of the Bone Marrow: Malignant Lymphoma – Multiple Myeloma – Bone Marrow

“…In patients suffering from polycythemia vera ( fig. 4), the bone marrow of the axial skeleton is diffusely and homogeneously hypointense on T1-weighted images and indistinguishable from the marrow abnormalities observed in leukemic patients [34]. The bone marrow MRI findings of patients with mastocytosis were reported by Avila and co-workers [38].…”

“…Infiltration and replacement of the hematopoietic marrow by fibrotic tissue results in a lowering of marrow signal intensity on MRI of all conventional sequence types [34,35]. The diminished signal intensity on T2-weighted images is a feature that is also observed in Gaucher's disease [36].…”

Magnetic resonance imaging of the bone marrow in hematological malignancies

“…In a series of 80 adult patients with acute leukemia, signal intensity of the vertebral bone marrow was lower than that of discs in 73 The appearance of the appendicular skeleton marrow in patients with acute leukemia is more variable [18, 20, 23, 85±87]. In patients with myeloproliferative disorders including chronic myelogeneous leukemia and polycythemia vera, the extent of marrow infiltration in the appendicular skeleton correlates with the spleen size, which is a parameter indicative of disease extent [87,88].…”