慢性粒细胞白血病骨髓磁共振成像表现及临床应用分析

目的探讨慢性粒细胞白血病(chronicmyeloid leukemia,CML)骨髓磁共振成像(MRI)表现及临床价值。方法收集成人CML50例,其中初诊慢性期患者16例,治疗后病情稳定于慢性期者18例,病情发展到加速期者7例,发生急性变者9例。所有患者均行骨盆及股骨中上段MRI检查。结果初诊慢性期及进展到加速和急变期的患者SE序列T1WI表现为髂骨及股骨骨髓弥漫性低信号或仅有在股骨头、大转子处残留斑片状高信号。治疗后维持在慢性期的患者SE序列T1WI表现为髂骨弥漫性低信号为主,夹杂点片状高信号,股骨主要表现为高低混杂信号。初诊慢性期组与治疗后组、治疗后组与加速急变组MRI表现差异有统计学意义(P<0.01);初诊慢性期组与加速急变期组差异无统计学意义(P>0.05)。结论CML患者骨髓MRI能反映其病程演变,与临床特点结合,有助于CML的诊断分期,对监测病情发展、提示加速和急变有重要价值。

Magnetic resonance imaging of bone marrow in patients with chronic myeloid leukemia and its clinical value

Objective To describe the magnetic resonance imaging(MRI) characteristics of chronic myeloid leukemia(CML) and to assess its clinical value for diagnosing and staging . Methods MRI of pelvis and femur was performed on 50 adult patients diagnosed as chronic myeloid leukemia based on morphology,immunophenotype and cytogenetic analysis. Disease status was classified as newly diagnosed chronic phase in 16 cases, steady chronic status in 18 cases having accepted effective treatment, accelerated phase in 7 cases, and blast phase in 9 cases after a long chronic phase. Twenty age-matched healthy volunteers were selected as controls. Results MRI patients newly diagnosed as chronic phase and transformation into accelerated or blast phases on T1WI spin echo showed either diffusal and uniform low signal intensity in ilium and femur or only punctate sheet high signal intensity was seen in femoral head and greater trochanter. The distribution of the patterns had no statistical significance(P>0.05). The 18 cases in steady chronic status who had accepted long time treatment showed diffusal low or mixed signal intensity in ilium and irregular mixed signal intensity in femur .There was significant difference between this group and the above groups(P<0.01). Conclusion The characteristics of MRI reflect the progression of chronic myeloid leukemia. MRI would be beneficial to CML′s diagnosing and staging together with considerations of clinical features. It had important value in monitoring disease and indicating depravation.