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Analysis of Diffusion Changes in Posttraumatic Bone Marrow Using Navigator-Corrected Diffusion Gradients

Robert Ward1, Shelton Caruthers1, Corrie Yablon1, Michael Blake1, Mathew DiMasi1 and Stephen Eustace1,2

1 Department of Radiology, Boston Medical Center, 88 E. Newton St., Boston, MA 02118.
2 Present address: Department of Radiology, Cappagh Orthopedic Hospital, Cappagh, Finglas, Co. Dublin, Ireland.



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  		Fig. 1A. —25-year-old man with rotational torque injury. Coronal short tau inversion recovery image (inversion time, 160; TR/TEeff, 2000/20) shows globular bone bruise (arrow) of lateral tibial plateau.

 


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  		Fig. 1B. —25-year-old man with rotational torque injury. Coronal apparent diffusion coefficient map shows minimal localized increase in diffusion (arrow) (apparent diffusion coefficient = 0.5 x 10-5 cm2/sec) at site corresponding to epicenter of bruise.

 


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  		Fig. 2A. —28-year-old man with rotational torque injury and nondisplaced anterior cruciate ligament avulsion from intercondylar notch, Coronal short tau inversion recovery image (inversion time, 160; TR/TEeff, 2000/20) shows focal marrow edema (arrow) oriented perpendicular to axis of stress at site of avulsion.

 


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  		Fig. 2B. —28-year-old man with rotational torque injury and nondisplaced anterior cruciate ligament avulsion from intercondylar notch, Coronal apparent diffusion coefficient map shows marked localized increase (arrow) in diffusion (apparent diffusion coefficient = 1.2 x 10-5 cm2/sec) perpendicular to axis of stress at site of avulsion.

 


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  		Fig. 3A. —42-year-old man after rotational torque injury with anterior cruciate ligament tear. Coronal short tau inversion recovery image (inversion time, 160; TR/TEeff, 2000/20) shows globular poorly marginated bone bruise of posterolateral tibial plateau with associated marginal depression fracture (arrow).

 


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  		Fig. 3B. —42-year-old man after rotational torque injury with anterior cruciate ligament tear. Sagittal fast spin-echo proton density-weighted image (2000/20) shows compression fracture of posterolateral tibial plateau (arrow). No contrecoup bruise or injury is identified in mid lateral femoral condyle because imposed forces are decompressed by fracture at posterolateral margin of tibial plateau.

 


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  		Fig. 3C. —42-year-old man after rotational torque injury with anterior cruciate ligament tear. Coronal apparent diffusion coefficient map shows diffuse markedly increased diffusion (apparent diffusion coefficient = 1.3 x 10-5 cm2/sec) at site of compression fracture and bruising (arrow and arrowheads).

 

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