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Mastocytosis: magnetic resonance imaging patterns of marrow disease
N A Avila1, A Ling, D D Metcalfe
1Diagnostic Radiology Department, Warren Grant Magnuson Clinical Center, National Institutes of Health, Bethesda, MD 20892, USA.
Objective:
To report the bone marrow MRI findings of patients with mastocytosis and correlate them with clinical, pathologic, and radiographic features.
Design And Patients:
Eighteen patients with mastocytosis had T1-weighted spin echo and short tau inversion recovery MRI of the pelvis at 0.5 T. In each patient the MR pattern of marrow disease was classified according to intensity and uniformity and was correlated with the clinical category of mastocytosis, bone marrow biopsy results, and radiographic findings.
Results:
Two patients had normal MRI scans and normal bone marrow biopsies. One patient had a normal MRI scan and a marrow biopsy consistent with mastocytosis. Fifteen patients had abnormal MRI scans and abnormal marrow biopsies. There were several different MR patterns of marrow involvement; none was specifically associated with any given clinical category of mastocytosis. Fifteen of the 18 patients had radiographs of the pelvis; of those, 13 with abnormal MRI scans and abnormal marrow biopsies had the following radiographic findings: normal (nine); sclerosis (three); diffuse osteopenia (one).
Conclusion:
While radiographs are very insensitive for the detection of marrow abnormalities in mastocytosis, MRI is very sensitive and may display several different patterns of marrow involvement.
Insights
Magnetic resonance imaging (MRI) is highly sensitive for detecting bone marrow abnormalities in mastocytosis, unlike radiography. MRI can reveal diverse patterns of marrow involvement, aiding diagnosis.
Area of Science:
- Radiology
- Oncology
- Hematology
Background:
- Mastocytosis is a rare disorder characterized by abnormal mast cell accumulation in tissues.
- Accurate assessment of bone marrow involvement is crucial for diagnosis and management of mastocytosis.
- Conventional radiography has limitations in detecting early or subtle bone marrow changes.
Purpose of the Study:
- To evaluate bone marrow magnetic resonance imaging (MRI) findings in patients diagnosed with mastocytosis.
- To correlate MRI findings with clinical presentations, pathological results, and radiographic features.
- To determine the sensitivity of MRI in detecting bone marrow abnormalities in mastocytosis.
Main Methods:
- Eighteen patients with mastocytosis underwent pelvic MRI using T1-weighted spin echo and short tau inversion recovery sequences at 0.5 T.
- MRI patterns of bone marrow disease were classified based on intensity and uniformity.
- Correlations were established between MRI findings, clinical mastocytosis categories, bone marrow biopsy results, and pelvic radiographs.
Main Results:
- Fifteen out of eighteen patients demonstrated abnormal MRI scans and bone marrow biopsies.
- Two patients had normal MRI scans and bone marrow biopsies; one had a normal MRI but biopsy-confirmed mastocytosis.
- Various MRI patterns of marrow involvement were observed, but none were specific to particular clinical mastocytosis subtypes. Radiographs showed limited sensitivity, with only 13 of 15 patients with abnormal MRI and biopsies exhibiting findings like sclerosis or osteopenia.
Conclusions:
- Bone marrow MRI is a highly sensitive imaging modality for detecting mastocytosis-related bone marrow abnormalities.
- MRI can depict diverse patterns of marrow involvement, offering valuable diagnostic information.
- Conventional radiography is significantly less sensitive than MRI for identifying bone marrow changes in mastocytosis.