Magnetic resonance imaging of bone marrow in sickle cell disease: clinical,
hematologic, and pathologic correlations
VN Mankad, JP Williams, MD Harpen, E Manci, G Longenecker, RB Moore, A Shah, YM Yang and BG Brogdon
Comprehensive Sickle Cell Center, University of South Alabama, Mobile.
A longitudinal, prospective, controlled evaluation of magnetic resonance
images (MRI) of long bones in sickle cell patients was undertaken
simultaneously with assessment of clinical status and hematologic
parameters, including dense erythrocytes. MRI of bone marrow in sickle cell
patients during steady states appeared patchy and were markedly different
from those in matched controls (P approximately 0). Patients with severe
patchiness were older than those with mild or moderate patchiness (P less
than .03). Sixty-nine MRI were performed during 28 painful episodes
occurring in 14 subjects with sickle cell disease (SCD). Increased signals
on intermediate and T2-weighted images were detected in 35.7% of painful
episodes. These abnormalities were distinct and not observed to occur
spontaneously during the steady- state examinations (P approximately 0).
Bone marrow infarcts were confirmed by biopsy in two instances and autopsy
in one instance. Dense red cells decreased by 40.81% of baseline during
pain crises (P = .00005), more remarkably in those who had pain in the
lower extremities (P = .0145). Patients with change in MRI during pain
crises had a greater percentage change in the dense cells than those
without the change in MRI (69.7% v 31.3%, P = .0120).
Volume 75,
Issue 1,
pp. 274-283,
01/01/1990
Copyright © 1990 by The American Society of Hematology
