MR imaging of the spinal bone marrow

Adequate interpretation of a cervical, thoracic, or lumbar spine MR imaging examination includes a careful evaluation of the bone marrow. Detecting an abnormality in bone marrow may cause a diagnostic dilemma because the marrow in the spine can vary in appearance according to the patient's age, and can be affected by infectious, inflammatory, metabolic, and neoplastic processes. Its appearance can be affected as well by underlying degenerative disc disease, trauma, and numerous iatrogenic therapies, including vertebroplasty, radiation therapy, and medications. In addition to conventional MR imaging sequences, newer imaging techniques, such as diffusion weighting and opposedphase sequences, are being studied to help increase the diagnostic accuracy of spine and bone marrow evaluation and to help differentiate benign from malignant and infectious processes.