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소아 골수의 MR 영상 소견

MR Imaging Features of Pediatric Bone Marrow

  • 염아림 (성균관대학교 의과대학 삼성서울병원 영상의학과) ;
  • 유소영 (성균관대학교 의과대학 삼성서울병원 영상의학과) ;
  • 전태연 (성균관대학교 의과대학 삼성서울병원 영상의학과) ;
  • 박지은 (성균관대학교 의과대학 삼성서울병원 영상의학과) ;
  • 김지혜 (성균관대학교 의과대학 삼성서울병원 영상의학과)
  • Arim Yeom (Department of Radiology, Sungkyunkwan University School of Medicine, Samsung Medical Center) ;
  • So-Young Yoo (Department of Radiology, Sungkyunkwan University School of Medicine, Samsung Medical Center) ;
  • Tae Yeon Jeon (Department of Radiology, Sungkyunkwan University School of Medicine, Samsung Medical Center) ;
  • Jieun Park (Department of Radiology, Sungkyunkwan University School of Medicine, Samsung Medical Center) ;
  • Ji Hye Kim (Department of Radiology, Sungkyunkwan University School of Medicine, Samsung Medical Center)
  • 투고 : 2024.03.09
  • 심사 : 2024.05.16
  • 발행 : 2024.05.01

초록

MRI는 골수의 평가에 있어 가장 예민도가 높은 검사로서 골수 질환의 진단에 있어 매우 중요한 역할을 한다. 그러나, 소아 영상을 자주 접하지 않는 영상의학과 의사들에게는 종종 정상 골수와 병적 골수의 구분이 어려울 수 있고, 소아의 흔한 악성질환인 백혈병이나 신경모세포종의 전이 등 골수를 침범하는 질환들이 임상적으로 다양한 근골격계 증상으로 발현하여 근골격 MRI 검사를 통해 진단되기도 한다. 소아에서 시행되는 MRI를 정확하게 판독하려면 골수의 정상 구성 성분에 대한 이해뿐만 아니라 나이에 따른 골수의 변화(age-related developmental change)와 소아에서 흔하게 골수를 침범하는 질환들에 대한 이해가 중요하다. 본 종설에서는 정상 골수의 구성과 소아 골수의 정상 및 비정상 MRI 소견을 기술하고 백혈병, 신경모세포종의 전이 등의 악성 골수 질환을 중심으로 임상 증례들을 고찰하고자 한다.

MRI plays a crucial role in bone marrow (BM) assessment, and has very high sensitivity in diagnosing marrow disorders. However, for radiologists who may not frequently encounter pediatric imaging, distinguishing pathologic BM lesion from normal BM can be challenging. Conditions involving the BM in pediatric patients, such as leukemia and metastatic neuroblastoma, often manifest with diverse musculoskeletal symptoms and may be diagnosed using musculoskeletal MRI examinations. Accurate interpretation of pediatric MRI requires not only an understanding of the normal composition of BM but also an awareness of age-related developmental changes in the marrow and familiarity with conditions that commonly involve pediatric BM. We aim to describe the composition of normal BM and outline the normal and abnormal MRI findings in pediatric BM. Additionally, we aim to present clinical cases of malignant BM disorders including leukemia, neuroblastoma metastasis, and other malignant BM disorders.

키워드

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