Glenn A. Tung MD, Abstract Co-Author: Nothing to Disclose

Jon P. Dyle PhD, Abstract Co-Author: Nothing to Disclose

Deborah McK Ciombor, Abstract Co-Author: Nothing to Disclose

Edward Jung MD, Abstract Co-Author: Nothing to Disclose

Alice M. Kim MD, Presenter: Nothing to Disclose

Roy K. Aaron, Abstract Co-Author: Nothing to Disclose

Bone marrow edema (BME)can be associated with osteoarthritis (OA), avascular necrosis (AVN), and other causes. Its pathophysiology remains largely unknown. In this study, we compare perfusion kinetics of normal marrow and BME using dynamic, contrast-enhanced (DCE)-MRI.

DCE-MR imaging of the knee (n=15), hip (n=8), or ankle (n=2) was performed on 25 adults using a 1.5T magnet. VIBE sequence was performed before and during IV administration of 0.1mmol/kg of gadodiamide at 2cc/sec. Uniform ROIs were placed on BME and normal marrow to generate time-intensity curves. DCE-MRI images were analyzed with customized IDL 6.1 software. Pharmacokinetic modeling was performed using the Brix model to generate values for initial slope, amplitude parameter (A), and rate constants of gadodiamide transfer from interstitial space to plasma (kep), and elimination from plasma (kel). Student’s t- and nonparametric tests were used to compare kinetic parameters.

There were 17 women and 8 men; mean age, 55.2 yrs (range, 22-92); OA was present in 13; AVN, 9; nonspecific BME, 3. Compared to normal marrow, kinetic parameters of enhancement in areas of BME included higher initial slope [(BME, 95.2±50.1 (mean±st dev); normal marrow, 50.7±38.1; p<.001], higher A (0.99±0.42; 0.44±0.35; p<.001), lower kep (3.58±2.98; 5.40±4.44; p=.004), and lower kel (-0.037±0.036; 0.091±0.021; p<.001). In areas of BME around AVN, there was significantly lower A (AVN, 0.64±0.41; OA, 1.14±0.33; p=.009) and lower kel (-0.058±0.042; -0.023±0.034; p=.04) compared to BME adjacent to OA, but no significant difference in either initial slope (70.35±65.80; 111.79±46.87; p=.06) or kep (4.90±3.99; 3.20±2.63; p=.26).

DCE-MRI can be used to investigate enhancement kinetics in bone marrow and demonstrates relative increased perfusion and permeability but slow transfer of gadodiamide from the vascular space to areas of BME. Kinetic analysis of contrast-enhancement shows differences in BME associated AVN compared to osteoarthritis.

DCE-MRI shows differences in enhancement kinetics between normal and edematous bone marrow.

Tung, G, Dyle, J, Ciombor, D, Jung, E, Kim, A, Aaron, R, Normal and Edematous Bone Marrow: Insights from Kinetic Analysis of Dynamic Contrast-enhanced MR Imaging.  Radiological Society of North America 2007 Scientific Assembly and Annual Meeting, November 25 - November 30, 2007 ,Chicago IL. http://archive.rsna.org/2007/5003886.html