Philippa Tyler MBBS, Presenter: Nothing to Disclose

Asif Saifuddin MRCP, FRCR, Abstract Co-Author: Nothing to Disclose

Madhuchanda Bhattacharyya MBBS, MRCP, Abstract Co-Author: Nothing to Disclose

Aim: 1. Recognise normal variants of lumbar spine marrow patterns on MRI 2. Learn how to differentiate between bone marrow oedema and marrow replacement 3. Learn how to differentiate between fibrosis, marrow hyperplasia and sclerotic metastases 4. Understand the role of DWI in difficult cases of marrow abnormality

  -Summary of changes in distribution and appearance of fatty marrow with patient age -Overview of Modic changes 1-3 -Relative marrow signal intensity on T1 (marrow signal vs disc) to determine the presence of marrow abnormality -Significance of location of bone marrow oedema within the vertebra  (eg parallel to end plates vs corners of vertebral body vs ventre of vertebral body vs posterior elements) -Significance of vertebral body deformity -DWI as additional diagnostic aid

Lumbar spine MRI is commonly performed in patients with  back pain, with or without radiculopathy. Changes of signal intensity within the lumbar vertebrae are a common finding We review normal and abnormal appearances of the vertebral bone marrow signal on MRI, demonstrating how to differentiate between  normal aging process, Modic-type endplate changes, discitis, enthesopathy, marrow replacement and reconversion. The use of DWI in differentiating benign from malignant processes is demonstrated.

Tyler, P, Saifuddin, A, Bhattacharyya, M, MR Imaging of the Lumbar Spine: An Approach to Marrow Abnormalities.  Radiological Society of North America 2010 Scientific Assembly and Annual Meeting, November 28 - December 3, 2010 ,Chicago IL. http://archive.rsna.org/2010/9002215.html