全身弥散成像对多发性骨髓瘤的诊断价值初探

目的:探讨磁共振全弥散成像技术在多发性骨髓瘤病人中的初步应用情况.方法:对17例临床确诊及疑似的多发性骨髓瘤病人行全身弥散检查,总结其全身弥散图像特点,探讨ADC值与其骨穿结果的相关性(骨髓增生情况、浆细胞比例).结果:全身弥散成像对多发性骨髓瘤病人的检出敏感性较高(12/13).髂骨骨髓病灶的ADC值大小与骨髓增生情况(骨穿结果)存在相关性,且不同增生情况组间的ADC值差异具统计学意义,但ADC值与骨髓浆细胞比例无线性相关性.结论:磁共振全身弥散成像一次可完成全身显像,无需引入外源性造影剂,无电离辐射,其敏感性高,且ADC值的减低程度可反映骨髓的增生情况,故磁共振全身弥散成像对多发性骨髓瘤病人的辅助诊断及鉴别诊断具有一定的参考价值.

Study of Whole-body Diffusion Weighted Imaging for Clinical Diagnosis of Multiple Myeloma

Purpose: To analyze the value of whole-body diffusion weighted imaging (WB-DWI) for clinical diagnosis of multiple myeloma. Methods: The MRI WB-DWI sequence was performed on 17 cases clinical confirmed or suspected multiple myeloma. We summarized the characteristics of the images of the confirmed patients and the relevance between the ADC values and the results of the bone marrow aspiration (the status of bone marrow hyperplasia, the percentage of plasma cells) . Results: Our follow up results proved that the WB-DWI is sensitive in detecting the cases with multiple myeloma (12/13) . The ADC values of the lesions on ilium had relevance with bone marrow hyperplasia. There was statistical significant difference between different bone marrow hyperplasia. The ADC value did not have liner relevance with the percentage of plasma cells.Conclusion: The MRI WB-DWI sequence can get the whole body images without introducing exogenous contrast agent. WB-DWI is sensitive in detecting the cases with multiple myeloma and the ADC values can reflect the status of the bone marrow hyperplasia. The MRI WB-DWI has clinical significance in the auxiliary diagnosis and differential diagnosis for multiple myeloma.