Clinical significance of magnetic resonance imaging of bone marrow in patients with leukemia.

To investigate the clinical significance of magnetic resonance imaging (MRI) of bone marrow in patients with acute leukemia, the femoral and pelvic marrow were evaluated by using MRI with a T1-weighted spin-echo (SE) method and a short T1 inversion recovery (STIR) technique. Normal bone marrow examination was performed with coronal T1-weighted MRI of pelvis and femurs, and showed persistent red marrow. There was a bright signal of fatty marrow in the femoral epiphyses and apophyses. MRI pattern of bone marrow in the 54 cases of acute leukemia showed abnormal signal patterns of femoral and pelvic marrow: (1) grade I (n = 4), (2) grade II (n = 11), (3) grade III (n = 8), (4) grade IV (n = 17), and (5) graded V (n = 14). Leukemic cells had infiltration onseted by red marrow in adult patients with leukemia. The marrow of femur had infiltration from diaphysis to epiphysis, and to femoral head and greater trochanter. The lower grades (grade IV, V) of leukemic marrow supported the diagnosis of AML in MRI, which achieved higher complete remission. The adult patients with ALL had higher grades (grade I-III) in MRI. Our findings indicated that MRI of femoral marrow is an important tool for accurate diagnosis and management of patients with leukemia that may function as an adjunct to bone marrow aspiration and biopsy. The pattern of MRI in patients with newly diagnosed leukemia predicted the prognosis and CR of leukemia.