{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T07:21:34Z","timestamp":1779175294331,"version":"3.51.4"},"reference-count":40,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2018,3,5]],"date-time":"2018-03-05T00:00:00Z","timestamp":1520208000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Magnetic Resonance Imaging"],"published-print":{"date-parts":[[2018,10]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>The diffusion\u2010weighted imaging (DWI) signals of the female pelvic bone marrow show great variability and are usually high in female patients with fibroid\u2010associated symptoms and anemia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Purpose<\/jats:title><jats:p>To ascertain clinical factors contributing to high signal intensity in the bone marrow of the female pelvis on DWI.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Type<\/jats:title><jats:p>Retrospective case\u2013control study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Subjects<\/jats:title><jats:p>A single\u2010institution review of 221 female patients underwent a pelvic magnetic resonance study from December 2012 to July 2014.<\/jats:p><\/jats:sec><jats:sec><jats:title>Field Strength\/Sequence<\/jats:title><jats:p>1.5T\/DWI (b\u2009=\u20090 and 1000) and apparent diffusion coefficient (ADC).<\/jats:p><\/jats:sec><jats:sec><jats:title>Assessment<\/jats:title><jats:p>The ADC of pelvic bone marrow and the muscle\u2010normalized signal intensity (SI) on DWI (mnDWI) were measured. A brightness grading scale ranging from 0 to 4 was used for pelvic bone assessment. Clinical factors, namely, age, the lowest hemoglobin level in the last 6 months, the presence of large uterine fibroids, and\/or adenomyosis and fibroid\u2010associated symptoms were recorded.<\/jats:p><\/jats:sec><jats:sec><jats:title>Statistical Tests<\/jats:title><jats:p>The relationships between the brightness grade and clinical factors were evaluated through multinomial logistic regression, and correlations of mnDWI and the ADC with the clinical factors were analyzed through the Kruskal\u2013Wallis test, Jonckheere's trend test, and the Mann\u2013Whitney <jats:italic>U<\/jats:italic>\u2010test with Bonferroni correction.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Age and the hemoglobin level were inversely associated with the bone marrow brightness grade on DWI (both <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.05), whereas the presence of fibroid\u2010associated symptoms showed a positive association (<jats:italic>P<\/jats:italic>\u2009=\u20090.028). The ADC and mnDWI in women younger than 50 years were significantly higher than those in older women (both <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.0001). The ADC had no significant correlation with anemia (<jats:italic>P<\/jats:italic>\u2009=\u20090.511), whereas mnDWI increased as the severity of anemia increased (<jats:italic>P<\/jats:italic>\u2009=\u20090.00154).<\/jats:p><\/jats:sec><jats:sec><jats:title>Data Conclusion<\/jats:title><jats:p>Our study showed an association of high DWI SI of pelvic bone marrow with anemia in premenopausal women.<\/jats:p><jats:p><jats:bold>Level of Evidence<\/jats:bold>: 4<\/jats:p><jats:p><jats:bold>Technical Efficacy<\/jats:bold> Stage 3<\/jats:p><jats:p>J. Magn. Reson. Imaging 2018;48:1024\u20131033.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jmri.26002","type":"journal-article","created":{"date-parts":[[2018,3,5]],"date-time":"2018-03-05T09:22:40Z","timestamp":1520241760000},"page":"1024-1033","source":"Crossref","is-referenced-by-count":11,"title":["High Signal in Bone Marrow on Diffusion\u2010Weighted Imaging of Female Pelvis: Correlation With Anemia and Fibroid\u2010Associated Symptoms"],"prefix":"10.1002","volume":"48","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8644-9751","authenticated-orcid":false,"given":"Ying\u2010Yuan","family":"Chen","sequence":"first","affiliation":[{"name":"Department of Radiology National Yang\u2010Ming University Hospital Yilan County Taiwan ROC"},{"name":"School of Medicine National Yang\u2010Ming University Taipei Taiwan ROC"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ching\u2010Lan","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Radiology Taipei Veterans General 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