Contrast-enhanced magnetic resonance imaging of bone marrow

In the assessment with magnetic resonance (MR) imaging of bone marrow disorders, the use of contrast agents is usually not critical because T1-weighted spin-echo and fat-suppressed sequences (STIR or fat-sat intermediate weighted) are robust and largely available techniques for depiction of neoplastic and non-neoplastic lesions of the bone marrow. This article discusses the characteristics of dynamic contrast-enhanced MR imaging of bone marrow edema, ischemia, and neoplasm. It emphasizes its value in staging and in monitoring of response to chemotherapy of several bone tumors. These fast dynamic contrast-enhanced techniques do not allow differentiation between benign and malignant primary osseous tumors because the biologic behavior rather than the malignant potential of these lesions is reflected.