Assessment and comparison of normal age related changes in spinal bone marrow on magnetic resonance imaging in relation to T1, T2 and STIR sequences
Shahnwaz Ali Khan, Tanu Singh, Santosh Ojha, Anupam Nirula, Dhiraj Kumar, Mir Rizwan Aziz, Nitish Virmani, BB Sharma
Background: Interpretation of bone marrow on magnetic resonance imaging (MRI) requires an understanding of normal pattern of maturation or conversion, as well as an understanding of hematopoietic and fatty constituents of marrow which contribute to the normal MRI appearance. The in depth knowledge of normal appearance of marrow intensity allows for recognition of pathologic marrow process.
Aim: The aim of this study was to see normal distribution of age related changes in bone marrow.
Material and Method: A prospective and comparative study was carried out from August 2018 to April 2019 in the Department of Radio-imaging and Diagnosis at SGT University Hospital, Gurugram. A total of 56 asymptomatic subjects were taken as a sample. Sagittal images were acquired on MRI, and signal intensity were measured on the level of D12, L1, L2 vertebras on T1, T2, STIR weighted images. A comparative study of signal intensity and age was done for the assessment of normal age related changes.
Result: In this study 56 asymptomatic subjects were taken as a sample comprising 33 male and 23 female. The average signal intensity (SI) calculated on T1 weighted images (T1WI) were lowest as 682.25 and highest being 862.28. On T2 weighted images (T2WI) THE lowest was 598.57 and the highest being 946.25. Short tau inversion recovery (STIR) images had shown the lowest signal intensity being 52.56 and the highest as 733.59. T1WI showed linear relation with p˂.05. T2WI also showed linear relation with age with p˂.05. STIR did not show any particular relation with age. There was more rapid change in bone marrow from red to yellow in male population than female counterpart.
Conclusion: The signal intensity in T1WI and T2WI had shown significant relation with age. MRI with its variety of sequences is proven to show different patterns of marrow in normal spine which is a key factor in assessment of pathologic conditions. The conversion of red marrow to fatty marrow and its reconversion to red marrow under stimuli like physiologic stress seems to be common.