Magnetic resonance imaging of bone marrow in sickle cell patients

Assessment of the bone marrow in sickle cell patients with or without pain crises can be accomplished using a variety of imaging techniques. Conventional radiography is the least sensitive of all imaging modalities in the early stages of the bone marrow infarct. Radionuclide imaging using 99mTc sulfur colloid shows sharply demarcated photon-deficient regions that are slow to resolve. Cumulative exposure to ionizing radiation would be of concern if repeated examinations with conventional x-rays and radionuclides were carried out. Magnetic resonance imaging (MRI) is a noninvasive technique that differentiates the bone marrow of sickle cell patients from that of normal controls. Furthermore, at least in some patients, acute tissue changes can be detected during early stages of pain crises using magnetic resonance. Further investigations are necessary to optimize the use of MRI in sickle cell patients with pain crises.