急性白血病骨髓MRI定性和定量诊断价值

目的　通过观察急性白血病治疗前后骨髓的MRI表现和T1及对比噪声比 (CNR)的测定 ,对照临床、病理资料 ,探讨急性白血病骨髓MRI定性和定量诊断价值。材料与方法　选择经临床确诊为急性白血病的患者 38例 ,缓解组 2 5例 ,对照组 35例进行MRI检查及T1值和CNR的测定。结果　急性白血病T1WI:治疗前组 38例 ,腰骶椎、髂骨及股骨近段均表现为信号降低 ;化疗缓解组 2 5例表现为不同程度的信号增高。T2 WI :38例治疗前组和 2 5例化疗后组各椎体、髂骨、股骨上段呈等信号。外周血B %、骨髓B %、腰椎T1值、腰椎 /皮下脂肪CNR、股骨骨髓 /皮下脂肪CNR于急性白血病治疗前组与正常对照组、治疗前组与缓解组间的差异均有显著性 (P <0 .0 5 ) ,缓解组与正常对照组间的差异无显著性 (P >0 .0 5 ) ,不同细胞类型间的差异无显著性 (P >0 .0 5 )。腰椎T1值于不同性别、年龄组间的差异无显著性 (P >0 .0 5 )。治疗前组骨髓B %与腰椎T1值、腰椎 /皮下脂肪CNR ,外周血B %与腰椎T1值、腰椎 /皮下脂肪CNR及腰椎T1值与腰椎 /皮下脂肪CNR之间成直线相关 (P <0 .0 5 )。结论　急性白血病的MRI检查为一种无创性检查方法 ,MRI表现具有一定的特征性 ,在估计病情的严重程度及治疗效果的评价简便实用 ,为避免多次重复骨髓穿刺检查以及全面

The Value of MRI in Qualitative and Quantitative Diagnosis of Acute Leukemia

Objective To evaluate MRI in qualitative and quantitative diagnosis of acute leukemia by observing the MRI findings of bone marrow, calculating T 1 and CNR (contrast noise ratio) before and after chemotherapy, and by comparing clinical and pathological data.Materials and Methods MRI scanning, T 1 value and CNR measuring were performed in study group (38 acute patients), remission group (25 cases) and control group (35 healthy volunteers).Results Before treatment hypointense signal on T 1WI at lumbosacral vertebrae, iliac bone and proximal femur was seen in all 38 cases with acute leukemia. Isointense signal on T 2WI was found in all cases. The signal intensity on T 1WI tended to become normal in all 25 remission cases of acute leukemia. Isointense signal was also found on T 2WI in remission cases. Significant differences in B% of blood and marrow, T 1 value of lumbar vertebrea, CNR of lumbar vertebrea/subcutaneous fat, and CNR of femoral marrow/subcutaneous fat were existed between study group before treatment and both control group and remission group (P<0.05). No significant difference could be seen between remission group and control group (P>0.05), nor between cases with different cellular type, including ALL, AML, ALL AML (P>0.05). Positive linear correlation existed between B% of bone marrow and lumbar T 1 value, CNR of lumbar vertebrea/subcutaneous fat, between B% of peripheral blood and lumbar T 1 value, CNR of lumbar vertebrea/subcutaneous fat, and between lumbar T 1 value and CNR of lumbar vertebrea/subcutaneous fat (P<0.05).Conclusion Acute leukemia has some characteristics on MRI. As a non invasive technique, MRI is very useful in estimating the severity of the disease and in evaluating the therapeutic effect, refraining from repeated marrow puncturing.