CT对慢性淋巴细胞白血病肝、脾体积与骨髓象、血象之间关系的研究

目的慢性淋巴细胞白血病(chronic lymphocytic leukemia,CLL)的进展主要表现为大量淋巴细胞浸润至肝脏及脾脏内并导致肝脾肿大,本文采用IQQA-Liver自动分析软件测量肝、脾体积,探讨CLL肝、脾体积的变化是否同骨髓象、血象之间的变化存在相关性,为临床提供更多影像学信息及参考指标,辅助临床判断CLL患者病情的进展或缓解情况,同时亦为患者提供一个无创可靠的随访手段。方法回顾性收集15例经临床免疫表型分析、细胞流式术、骨髓活检等检查确诊(其中8例行个体化化疗)并复查随访的CLL病例,每次随访的患者前后均行全腹部或胸腹部MDCT扫描,且在行MDCT扫描的短期内(7天内)亦行骨髓象、血象等相关实验室检查,分析每例患者前后肝、脾体积变化与实验室骨髓象、血象变化之间的相关性。结果CLL患者的肝、脾体积及肝脾总体积与骨髓片、血片淋巴细胞比例计数之间有一定的相关性(r值分别为0.627、0.658、0.683及0.674、0.654、0.695,P值均<0.05)。结论MDCT辅以智能化自动分析软件可精确测量肝、脾体积,所测得的肝、脾体积的变化与骨髓、血片淋巴细胞计数变化呈中等程度相关,对CLL的进展、缓解及化疗效果的评估有一定的增益价值。

The study of the correlation of bone marrow and blood with the volume of liver and spleen in chronic lymphocytic leukemia

Objective Progress of chronic lymphocytic leukemia is characterized by a large number of lymphocyte infiltration to liver and spleen,which causes enlargement of liver and spleen.The aim of this study was to estimate the correlation of CLL bone marrow and blood with the volume of liver and spleen measured by IQQA-Liver software,to offer more imaging reference indicators in addition to laboratory tests,and to evaluate progress or release of CLL by a non-invasive measurement.Methods 15 patients with CLL proved by analysis of immunophenotyping,flow cytometry and bone marrow biopsy were involved as the follow-up group,among them 8 patients underwent individualized treatment.All the patients underwent total abdominal or thoracic-abdominal multi-detector CT(MDCT),followed by bone marrow,blood and other laboratory tests within a short time(7 days).The correlation of volume change of liver and spleen and laboratory tests including bone marrow and blood were analyzed.Results There were notable correlation between volume of liver and spleen and lymphocyte count in marrow and blood,r=0.627,0.658,0.683,P<0.05 and r=0.674,0.654,0.695,P<0.05 retrospectively.Conclusion Liver and spleen volume measurement by MDCT is simple and accurate.Change of volume of liver and spleen shows moderate relation with the change of lymphocyte count in marrow and blood.Volume of liver and spleen measured by MDCT is a potential value in progress,release and treatment evaluation of CLL patients.