NIV Congres

Background: Advanced imaging techniques as magnetic resonance imaging (MRI) is increasingly performed in the workup of patients with musculoskeletal complaints. Incidental bone marrow abnormalities may be detected with these imaging techniques, as MRI can visualize different components of the bone marrow. In the last years several patients have been referred to the hematology department because of an abnormal bone marrow signal detected on MRI. The clinical significance of these signal alterations is unknown. The main goal of this study was to determine the diagnostic value of signal alterations of bone marrow in the diagnosis of haematological disorders and to define guidelines towards invasive diagnostic interventions like bone marrow puncture.

Patients and Methods: We retrospectively examined all bone marrow punctures performed from 2007 until 2012 (n = 1407) in the Maxima Medical Centre. Patients were included when the puncture was obtained following a MRI with an abnormal bone marrow signal. Patients who underwent MRI for a suspected malignancy were excluded. Thirteen patients were included. Histological and cytological Results of the bone marrow puncture were analyzed.

Results: In seven patients (7/13) clinical significant oncohaematological disorders were found. One patient was diagnosed with acute myeloid leukemia, one with a myelodysplastic syndrome, one with multiple myeloma, one with a monoclonal gammopathy of unknown significance, one with essential thrombocytosis, one with a congenital spherocytosis and one with metastases of an unknown primary tumor. Six patients had normal bone marrow histology and cytology.

Conclusion: This retrospective study showed oncohaematological disorders in 54% of the patients with incidentally detected signal alterations of bone marrow on MRI. We recommend that these patients receive a bone marrow examination to exclude hematological pathology.