| Objective To explore the characteristics of bone marrow in lumbar vertebra and femur mobilizatied by recombinant human granulocyte colony stimulating factor (rhG-CSF) by MRI and MRS in healthy peripheral blood stem cell donors.Methods A total of 62 healthy peripheral blood stem cell donors were included from July,2010 to November,2014 from the hemotology department. Lumbar MRI, chemical shift imaging, MRS and femoral MRI were performed at different time that the day before administration of rhG - CSF, the third day after administration of rhG-CSF,1 week after administration of rhG-CSF,2 weeks after administration of rhG-CSF,1 month after administration of rhG-CSF,2 months after administration of rhG-CSF. WBC count and CD34 + hemopoietic cells proportion of peripheral blood were measured at the same time. The signal intensity of lumbar and femural bone marrow were evaluated and the water fraction of L3 marrow 1H-MRS were calculated. The correlation of water fraction of L3 marrow 1H-MRS and peripheral blood WBC count and CD34 + cells proportion at different time were measured.Results Before administration of rhG-CSF, lumbar vertebral body showed homogeneously low signal in SE-T1WI and SE-T2WI sequence in younger donors, and slight high signal in CSI opposed phase. Proximal femur showed high signal, and only small patchy slightly low signal was seen in the femoral intertrochanteric. Lumbar vertebrae body presented banding, patchy or even homogeneous high signal in T1WI and T2WI sequence in older donors, and lower signal was seen in CSI opp phase. Homogeneous high signal was found in proximal femur. Water fraction of L3 marrow 1H-MRS was about 0.512±0.140. The correlation coefficient between fat fraction (FF) of L3 marrow and age was 0.633 (p< 0.001). The low signal intensity hemopoietic marrow of the lumbar spine and proximal femur was more common in SE-TIWI and SE-T2WI sequence at the 3rd day after administration of rhG-CSF, especially in the spine. And the signal intensity of lumbar increased than before in CSI opposed phase. Water fraction of L3 marrow 1H-MRS was about 0.640±0.132. About 1 week after administration of rhG-CSF, lumbar marrow signal intensity was homogeneously low in SE-T1WI and SE-T2WI sequence, but higher in CSI opposed phase. Low signal intensity red marrow increased in proximal femur in T1WI and T2WI sequence. Water fraction of lumbar marrow reached the peak to 0.792±0.097. About 2 weeks after administration of rhG-CSF, bone marrow of the lumbar was slight higher in SE-T1WI and SE-T2WI sequence than that of the 1st week, and the signal intensity dropped out in opposed phase. Proximal femoral bone marrow signal intensity also increased slightly. Water fraction of lumbar marrow was about 0.774±0.112. About 1 month after injection of rhG-CSF, the amount of fatty marrow in lumbar spine and femur increased in SE-T1WI and SE-T2WI sequence than that of the 2nd week, and signal intensity dropped in oppse phase. Water fraction of lumbar vertebrae was about 0.653± 0.129. About 2 months after injection of rhG-CSF, vertebral body and proximal femur showed the same signal intensity in SE-T1WI and SE-T2WI sequence compared to that before administration of rhG-CSF. Water fraction of lumbar marrow MRS decreased to about 0.542±0.124. Peripheral blood WBC count and the proportion of CD34 + hemopoietic cells increased gradually after injection of rhG-CSF, and reached peak to 48.53±6.44×109,0.58±0.19 about 1 week after administration of rhG-CSF. Then recover to the level before injection of rhG-CSF about 2 weeks after administration of rhG-CSF.Comparing to the water fraction (WF) of vertebral body before administration of rhG-CSF, differences were statistically significant in the 3rd day, the 1st week, the 2nd week and the 1st month (P< 0.05). Water fraction of lumbar marrow was not significant between pre-injection and the 2nd month (P> 0.05)Water fraction of lumbar vertebrae marrow correlated respectively with peripheral blood WBC count in the 3rd day and the 1st week(p<0.05), but the correlation between water fraction of lumbar marrow and the proportion of CD34 + hemopoietic cells was not significant (P>0.05)。Conclusion (1) MRI and MRS of bone marrow may be the noninvasive qualitative and quantitative indicators that reflecting extent and time course of the morphologic changes of bone marrow. (2) Fat fraction of vertebral marrow MRS correlates positively with age in normal adults. (3) After subcutaneous injection of rhG-CSF in healthy peripheral blood stem cell donors, bone marrow mobilization accompanies with the increasing of peripheral blood WBC count and CD34 + hemopoietic cells proportion. Both of them reached the peak at Day 5-7. (4) After discontinuous of rhG-CSF, the time that bone marrow recovers to normal level is slower than peripheral blood WBC count and the proportion of CD34 + cells. It needs about 2 months to return to basal levels. |
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