血液病骨髓动态增强MRI特征的初步研究

目的探讨血液病患者骨髓动态增强MRI(DCE-MRI)与骨髓细胞构成的关系。方法对25例恶性血液病患者进行DCE-MRI检查,测定骨髓灌注的最大强化率(PER)、最大强化斜率(Slopemax)、峰值时间(TTP)和平均时间(MT);30 min后进行髂嵴穿刺活检,分析细胞构成。结果25例血液病患者中,正常细胞数型骨髓20例,细胞数增多型骨髓3例,细胞数减少型骨髓2例。DCE-MRI骨髓时间-信号强度曲线(TIC)B型3例,C型7例,D型13例,E型2例。细胞数增多型骨髓PER、Slopemax均高于正常细胞数型骨髓和细胞数减少型骨髓;细胞数增多型骨髓TTP短于正常细胞数型骨髓和细胞数减少型骨髓;细胞数减少型骨髓MT短于正常细胞数型骨髓和细胞数增多型骨髓。结论DCE-MRI可以作为无创、有效监测血液病骨髓细胞构成变化的手段之一。

Preliminary result of dynamic contrast-enhanced MR imaging in assessment of cellularity characteristics of bone marrow in patients with haematological malignancies

OBJECTIVE: To evaluate the correlation of bone marrow status in haemotological malignancy patient with the variable value of dynamic contrast-enhanced MR (DCE-MRI). METHODS: DCE-MRI result were obtained from 25 patients with pathologically proven haematological malignancies. Time-signal intensity curves (TIC) was generated from the region of the iliac crest corresponding to the planned biopsy site. Enhancement characteristics including peak enhance ratio (PER) , maximum slope (Slopemax), time to peak ( TP) and mean time (MT) were analyzed. The patients received bone marrow biopsy on the crest 30 min after DCE-MRI, and then the parameters of bone marrow histology including cellularity was analyzed. RESULTS: In this series, 3 patients showed type B TIC, 7 type C, 13 type D and 2 type E. The bone marrow cellularity with haematological malignancies cannot be demostrated by TIC type. The mean PER value and Slopemax value in the patients with hypercellularity was significantly higher than that with normal cellularity and hypocellularity. The mean TTP value of the patients with hypercellularity (60.20 +/- 61.62) was significantly lower than that in the patients with hypocellularity (97.43 +/- 1.07) or normal cellularity (78.44 +/- 38.02). There was no significant difference in the mean MT value among three groups. CONCLUSION: Our preliminary findings suggest that the bone marrow cellularity in the patient with haematological malignancies can not be revealed by conventional MR, but it may be demonstrated by semi-quantitative calculation of the variable value from DCE-MR imaging.