Fig. 6.
Variegated MR pattern of abnormal marrow in a 45-year-old man with multiple myeloma: T1-weighted (600/20, TR/TE) (A), relatively T2-weighted gradient recalled echo (650/20, TR/TE, flip angle 20°) (B), and enhanced T1-weighted (600/20, TR/TE ) (C) sagittal MR images of the lumbar spine show multiple tiny foci of marrow involvement. Arrows point to island of normal fatty marrow. Sagittal T1-weighted (600/20, TR/TE) MR image 6 months after initiation of chemotherapy (D) shows reappearance of fatty marrow in the spine. Note development of multiple vertebral collapses. T1-weighted MR image 1 year after bone marrow transplantation and total body irradiation (600/20, TR/TE) (E) shows resolution of marrow abnormality and homogeneous bright signal of fatty marrow in the lumbar spine. Note progression of compression fractures. Reprinted with permission from Moulopoulos et al.14,21