MRI of bone marrow disorders

Four factors can be used in MR of bone marrow: fat-water distribution, artifacts induced by bone trabeculae, diffusion, and uptake of contrast media. Fat-water is imaged using T1-weighted spin-echo, short tau inversion recovery (STIR), and fast STIR, in- and out-of-phase gradient echo, and fat pre-saturation sequences, bone trabeculae by gradient echo with long TE; diffusion by single-shot spin-echo of contrast media is a more efficient way to improve the specificity. The value and limitations of those sequences are discussed in marrow replacements (metastases, lymphoma, leukemia) and in myeloid hyperplasia or depletion.