Bone marrow in leukemia and aplastic anemia: MR imaging before, during, and after treatment

Serial magnetic resonance (MR) studies of the cervical bone marrow were performed in five patients undergoing bone marrow transplantation for chronic granulocytic leukemia and in four patients with aplastic anemia who were treated with antilymphocytic globulin. Findings were compared with those from a group of healthy volunteers. Chemical shift imaging techniques were used to exploit the presence of protons in fat and water in the red marrow. Characteristic changes were seen in aplastic anemia before treatment, but derivation of images representing fat and water fractions was necessary to distinguish leukemic marrow. Acute changes during the treatment of leukemia may reflect the effects of chemotherapy and radiation therapy, whereas changes in the chronic phase of both diseases may prove useful in predicting treatment outcome. MR studies are likely to be useful in the assessment and treatment of hematologic disorders.