The Diagnostic Value of Abnormal Bone Marrow Signal Changes on Magnetic Resonance Imaging: Is Bone Marrow Biopsy Essential?

IF 1.1 4区 医学 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
Fatma Arikan, Yasin Yildiz, Rabia Ergelen, Isık Atagündüz, Tayfur Toptas
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Abstract

Background: It is essential to determine whether bone marrow signal changes on magnetic resonance imaging (MRI) represent a physiological response or pathology; at present, the clinical significance of these signal changes is unclear. It is unknown whether a bone marrow biopsy is required when bone marrow signal changes are detected incidentally in individuals without suspected malignancy.

Objective: The primary purpose of this study was to determine whether incidentally detected bone marrow signal changes on MRI performed for various reasons (at the time of admission or during follow-up) are clinically significant.

Methods: We retrospectively evaluated the bone marrow biopsy clinical and laboratory findings of 42 patients with incidental bone marrow signal changes on MRI between September 2016 and January 2020. We also determined whether the patients were diagnosed with malignancy during admission or follow-up.

Results: Of the 42 patients, three (7%) were diagnosed with hematological malignancies during admission, while two were diagnosed with multiple myeloma and one with B-cell acute lymphoblastic leukemia. Of the 42 patients, 35 had a mean follow-up of 40.6 ± 5.3 months. One patient was diagnosed with monoclonal gammopathy of undetermined significance four months after their first admission.

Conclusions: In addition to MRI, detailed clinical and laboratory evaluations should be performed to inform the decision for bone marrow biopsy and exclude hematological malignancy. If there is any doubt, a bone marrow biopsy should be performed. Moreover, since bone marrow signal changes may be a preliminary finding, follow-up of these patients is essential.

磁共振成像中异常骨髓信号变化的诊断价值:骨髓活检是否必要?
背景:确定磁共振成像(MRI)上的骨髓信号变化是生理反应还是病理变化至关重要;目前,这些信号变化的临床意义尚不明确。在没有疑似恶性肿瘤的个体中偶然发现骨髓信号变化时,是否需要进行骨髓活检尚不清楚:本研究的主要目的是确定因各种原因(入院时或随访期间)在磁共振成像中偶然发现的骨髓信号变化是否具有临床意义:我们回顾性评估了2016年9月至2020年1月期间42例磁共振成像偶然发现骨髓信号变化的患者的骨髓活检临床和实验室结果。我们还确定了患者在入院或随访期间是否被诊断为恶性肿瘤:42名患者中,3人(7%)在入院时被诊断为血液恶性肿瘤,2人被诊断为多发性骨髓瘤,1人被诊断为B细胞急性淋巴细胞白血病。42 名患者中,35 人的平均随访时间为 40.6±5.3 个月。一名患者在首次入院四个月后被诊断出患有意义未定的单克隆丙种球蛋白病:结论:除磁共振成像外,还应进行详细的临床和实验室评估,以决定是否进行骨髓活检,并排除血液恶性肿瘤。如有任何疑问,应进行骨髓活检。此外,由于骨髓信号变化可能只是初步发现,因此对这些患者进行随访至关重要。
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来源期刊
CiteScore
2.60
自引率
0.00%
发文量
246
审稿时长
1 months
期刊介绍: Current Medical Imaging Reviews publishes frontier review articles, original research articles, drug clinical trial studies and guest edited thematic issues on all the latest advances on medical imaging dedicated to clinical research. All relevant areas are covered by the journal, including advances in the diagnosis, instrumentation and therapeutic applications related to all modern medical imaging techniques. The journal is essential reading for all clinicians and researchers involved in medical imaging and diagnosis.
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