Mona Mohsen MD, Presenter: Nothing to Disclose

Murali Sundaram MD, Abstract Co-Author: Nothing to Disclose

Jean Pierre Schils MD, Abstract Co-Author: Nothing to Disclose

Carl Scherman Winalski MD, Abstract Co-Author: Institutional research contract, Smith & Nephew plc Contract, Smith & Nephew plc Contract, Johnson & Johnson Contract, sanofi-aventis Group Contract, Bioclinica, Inc Contrast, Axio Research Research Grant, The Procter & Gamble Company Shareholder, NitroSci Pharmaceuticals, LLC Shareholder, Pfizer Inc Shareholder, General Electric Company

Hakan Ilaslan MD, Abstract Co-Author: Nothing to Disclose

Histology of marrow biopsies in patients with multiple myeloma(MM) typically show abundant neovascularity, especially in advanced cases. In the elderly, pelvic bone marrow is usually composed of yellow(fatty) marrow which has a poor blood supply. We aimed to evaluate the degree of marrow vascular proliferation in MM patients comparing with age- matched control group.

Fifty consecutive patients with known MM who underwent unenhanced pelvic MRIs were included in the study. Control group was composed of 50 patients with no known malignancy in the same age group. T1-W and T2-W fat suppressed axial and coronal images of the pelvis were reviewed. MRIs were reviewed for presence of marrow blood vessels (subtle, moderately prominent and very prominent), and red marrow. MRIs of MM patients were additionally evaluated for presence or absence of focal myeloma lesions.

There were 18 females and 32 males. Age range of the patients was 41 to 88(average 61). In the MM group 6 patients had very prominent and 16 patients had moderately prominent bone marrow vascularity. Two MM patients had no appreciable marrow vascularity whereas 26 of patients had subtle vascularity. Four MM patients had completely fatty marrow and the remaining 46 had mild to moderate background of red marrow. In the control group, there were no patients with very prominent or moderately prominent bone marrow vascularity. Eight cases in the control group had no marrow vascularity visualized and 42 patients had subtle vascularity seen. Six patients in the control group had completely fatty marrow and the remaining 44 had mild areas of red marrow.

Prominent bone marrow vessels are evident on MRI in patients with known MM corresponding to this well known histologically well established finding .

In patients with an established diagnosis of MM, large marrow vessels should not be mistaken for lesions of myeloma. In the patient without known MM, the observation of large vessels in elderly patien

Mohsen, M, Sundaram, M, Schils, J, Winalski, C, Ilaslan, H, Increased Marrow Vascularity: An Unenhanced MRI Sign of Multiple Myeloma.  Radiological Society of North America 2013 Scientific Assembly and Annual Meeting, December 1 - December 6, 2013 ,Chicago IL. http://archive.rsna.org/2013/13023326.html