Diffuse T1 bone marrow signal loss

Diffuse T1 vertebral bone marrow signal loss is associated with replacement of fatty marrow by edema or cellular tissue. T1-weighted imaging without fat suppression is one of the most important sequences for distinguishing between normal and abnormal bone marrow. In the case of homogenous involvement, this appearance can often be difficult to spot as abnormal. 

Differential diagnosis

• bone marrow hyperplasia
• myeloproliferative and lymphoproliferative diseases
• myelofibrosis
• diffuse skeletal metastases
• iron deposition related pathologies, e.g. hemochromatosis
• sarcoidosis
• spondyloarthropathy
• renal osteodystrophy
• gout