To study the role of various magnetic resonance imaging sequences in assessment of vertebral marrow changes in postmenopausal Indian female population

Abstract

Background: Magnetic resonance imaging (MRI) appearance of vertebral bone marrow is highly variable varying with age and menopause in females. The differential appearance of marrow on various sequences can be used for assessing the marrow and studying the changes which are physiological with age and the changes which represent pathology. Objective: The aim and purpose of this study is to evaluate the patterns of changes in the appearance of vertebral bone marrow occurring with age and menopause in Indian females on MRI. Materials and Methods: MRI images of 60 female subjects −0.30 pre-menopausal females more than 25 years (25-35 and 35-45 years age group) and 30 post-menopausal females (45-55, 55-65, and more than 65 years age group) were evaluated. MRI was performed on 1.5 Tesla MRI Machine (Siemens Magnetom Avanto) and T1, T2 weighted and STIR images obtained in sagittal, axial, and coronal planes from D8 to L4 levels. Results: There was variation in the appearance of bone marrow among individuals with increasing fat content with age and menopause. It usually followed large globular fat deposition pattern (Pattern 4 described by Ricci et al.) in 60% of post-menopausal group and all cases more than 65 years of age had almost homogenously increased signal intensity of vertebrae probably due to prevalent osteoporosis in post-menopausal Indian females. None of the cases in post-menopausal group had fine punctuated fatty replacement of bone marrow (Pattern 3 described by Ricci et al.). Conclusions: MRI is a very helpful imaging modality in the evaluation of vertebral marrow changes with age and menopause but as the marrow is a tissue undergoing constant change its appearance on MRI is highly variable, and its accurate analysis requires radiological, acumen, expertise and a correct combination of various MRI pulse sequences.