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Updated: Apr 24, 2026
Quantitative Magnetic Resonance Imaging of Skeletal Muscle Disease
Published on: December 18, 2016
Incidentally detected diffuse signal alterations of bone marrow on MRI: is bone marrow biopsy indicated?
J Spierings1, A N van der Linden, P H M Kuijper
1Departments of Internal Medicine÷Haematology, Maxima Medical Centre, Eindhoven÷Veldhoven, the Netherlands.
Background:
Advanced imaging techniques as magnetic resonance imaging (MRI) are increasingly performed in the diagnostic workup of patients. Incidentally, diffuse signal alterations of the bone marrow are detected because MRI visualises various components of the bone marrow. The clinical significance of these signal alterations is unknown.
Objective:
The main goal of this study was to determine the diagnostic value of a bone marrow biopsy in patients with incidentally found diffuse signal alterations of the bone marrow.
Methods:
We retrospectively examined all bone marrow biopsies performed from 1 January 2007 to 31 December 2013 (n = 1947). Patients were included when the biopsy was obtained following an MRI with a diffuse abnormal bone marrow signal. Patients who underwent MRI for suspected malignancy were excluded. Histological and cytological results of the bone marrow examinations were analysed.
Results:
15 of the 1947 bone marrow biopsies (0.77%) were performed because of diffuse signal alterations on MRI. In seven of these 15 bone marrow biopsies (47%) a clinically important haematological disorder was found. Eight patients had a normal bone marrow evaluation.
Conclusion:
Based on this retrospective study, a bone marrow examination in patients with incidentally detected diffuse signal alterations should be considered to exclude haematological pathology. Prospective studies have to be performed to further investigate the best diagnostic strategy.
Insights
A bone marrow biopsy is valuable for diagnosing hematological disorders in patients with incidental MRI findings of diffuse bone marrow signal alterations. Further prospective studies are needed to refine diagnostic strategies.
Area of Science:
- Medical Imaging
- Hematology
- Diagnostic Pathology
Background:
- Magnetic resonance imaging (MRI) is frequently used in patient diagnostics.
- Incidental diffuse bone marrow signal alterations are often detected via MRI.
- The clinical significance of these MRI-detected bone marrow changes is not well understood.
Purpose of the Study:
- To evaluate the diagnostic utility of bone marrow biopsy for incidentally detected diffuse bone marrow signal alterations on MRI.
- To assess the rate of clinically significant hematological findings in this patient group.
Main Methods:
- Retrospective analysis of 1947 bone marrow biopsies from 2007-2013.
- Inclusion criteria: biopsy following MRI with diffuse abnormal bone marrow signal, excluding malignancy workup.
- Analysis of histological and cytological results from bone marrow examinations.
Main Results:
- 0.77% (15/1947) of biopsies were performed due to incidental diffuse MRI bone marrow signal alterations.
- 47% (7/15) of these biopsies revealed clinically important hematological disorders.
- 8 patients (53%) had normal bone marrow evaluations.
Conclusions:
- Bone marrow examination should be considered for incidental diffuse MRI bone marrow signal alterations to rule out hematological pathology.
- Further prospective research is required to establish optimal diagnostic pathways.
