中华放射学杂志
中華放射學雜誌
중화방사학잡지
Chinese Journal of Radiology
2011年
9期
817-821
,共5页
王峻%郝文静%牛金亮%苏晋生%李文晋%李俊峰%王煊%郑英%郑洁%宋志珍%李晓君%胥毅
王峻%郝文靜%牛金亮%囌晉生%李文晉%李俊峰%王煊%鄭英%鄭潔%宋誌珍%李曉君%胥毅
왕준%학문정%우금량%소진생%리문진%리준봉%왕훤%정영%정길%송지진%리효군%서의
急性白血病%骨髓%浸润%动态增强%磁共振成像
急性白血病%骨髓%浸潤%動態增彊%磁共振成像
급성백혈병%골수%침윤%동태증강%자공진성상
Acute leukemia%Bone marrow%Infiltration%Dynamic contrast enhancement%Magnetic resonance imaging
目的：采用动态增强MRI(DCE-MRI)分析急性白血病(AL)患者骨髓浸润微循环血流动力学特点及临床意义。方法 47例AL患者行快速小角度激发梯度同波(FLASH)序列T1WI冠状面髋部DCE-MRI，分别在腰椎及双侧髂骨设置ROI，绘制时间-信号强度曲线(ETCs)，计算最大强化率（Emax）、强化斜率(slope)。读取MR检查近期AL骨髓象中原始细胞所占比例。47例AL.患者分为3组：初发未治疗组、初发治疗完全缓解(CR)组及初发治疗未缓解(NR)组。比较AL患者不同部位（椎体及髂骨）骨髓浸润在DCE-MRI的差异；比较3组患者髂骨骨髓浸润Emax、slope值的差异，与骨髓象原始细胞计数对照分析其临床意义。对所获数据分别采用配对资料的t检验、方差分析及Pearson相关性分析。结果 47例AL患者髂骨骨髓Emax值(15.70±7.06)比腰椎(11.28±5.52)高，差异具有统计学意义(P＜0.01)；slope值分别为0.82±0.12和0.80±0.09，差异无统计学意义(P＞0.05)。25例仞发未治疗组髂骨骨髓Emax和slope分别为17.15±5.75和0.98±0.13,14例初发治疗CR组分别为8.76±3.93和0.26±0.04,8例初发治疗NR组分别为21.62±6.50和1.38±0.02,三组间Emax和slope差异均有统计学意义（P值均＜0.05）；初发治疗CR组的Emax及slope 值均低于初发未治疗组和仞发治疗NR组（P值均＜0.05）；初发未治疗组Emax及slope值均低于初发治疗NR组，但差异尤统计学意义(P＞0.05)。47例AL患者髂骨骨髓的Emax值与骨髓象原始细胞比例(25.6±4.2)％呈正相关(r ＝0.501,P＜0.05)，与slope值尤相关性(r＝0.235,P＞0.05)。结论 DCE-MRI是评估AL患者骨髓浸润微循环血流动力学的有效方法，可望为AL患者预后评价及疗效监测提供有价值的信息。
目的：採用動態增彊MRI(DCE-MRI)分析急性白血病(AL)患者骨髓浸潤微循環血流動力學特點及臨床意義。方法 47例AL患者行快速小角度激髮梯度同波(FLASH)序列T1WI冠狀麵髖部DCE-MRI，分彆在腰椎及雙側髂骨設置ROI，繪製時間-信號彊度麯線(ETCs)，計算最大彊化率（Emax）、彊化斜率(slope)。讀取MR檢查近期AL骨髓象中原始細胞所佔比例。47例AL.患者分為3組：初髮未治療組、初髮治療完全緩解(CR)組及初髮治療未緩解(NR)組。比較AL患者不同部位（椎體及髂骨）骨髓浸潤在DCE-MRI的差異；比較3組患者髂骨骨髓浸潤Emax、slope值的差異，與骨髓象原始細胞計數對照分析其臨床意義。對所穫數據分彆採用配對資料的t檢驗、方差分析及Pearson相關性分析。結果 47例AL患者髂骨骨髓Emax值(15.70±7.06)比腰椎(11.28±5.52)高，差異具有統計學意義(P＜0.01)；slope值分彆為0.82±0.12和0.80±0.09，差異無統計學意義(P＞0.05)。25例仞髮未治療組髂骨骨髓Emax和slope分彆為17.15±5.75和0.98±0.13,14例初髮治療CR組分彆為8.76±3.93和0.26±0.04,8例初髮治療NR組分彆為21.62±6.50和1.38±0.02,三組間Emax和slope差異均有統計學意義（P值均＜0.05）；初髮治療CR組的Emax及slope 值均低于初髮未治療組和仞髮治療NR組（P值均＜0.05）；初髮未治療組Emax及slope值均低于初髮治療NR組，但差異尤統計學意義(P＞0.05)。47例AL患者髂骨骨髓的Emax值與骨髓象原始細胞比例(25.6±4.2)％呈正相關(r ＝0.501,P＜0.05)，與slope值尤相關性(r＝0.235,P＞0.05)。結論 DCE-MRI是評估AL患者骨髓浸潤微循環血流動力學的有效方法，可望為AL患者預後評價及療效鑑測提供有價值的信息。
목적：채용동태증강MRI(DCE-MRI)분석급성백혈병(AL)환자골수침윤미순배혈류동역학특점급림상의의。방법 47례AL환자행쾌속소각도격발제도동파(FLASH)서렬T1WI관상면관부DCE-MRI，분별재요추급쌍측가골설치ROI，회제시간-신호강도곡선(ETCs)，계산최대강화솔（Emax）、강화사솔(slope)。독취MR검사근기AL골수상중원시세포소점비례。47례AL.환자분위3조：초발미치료조、초발치료완전완해(CR)조급초발치료미완해(NR)조。비교AL환자불동부위（추체급가골）골수침윤재DCE-MRI적차이；비교3조환자가골골수침윤Emax、slope치적차이，여골수상원시세포계수대조분석기림상의의。대소획수거분별채용배대자료적t검험、방차분석급Pearson상관성분석。결과 47례AL환자가골골수Emax치(15.70±7.06)비요추(11.28±5.52)고，차이구유통계학의의(P＜0.01)；slope치분별위0.82±0.12화0.80±0.09，차이무통계학의의(P＞0.05)。25례인발미치료조가골골수Emax화slope분별위17.15±5.75화0.98±0.13,14례초발치료CR조분별위8.76±3.93화0.26±0.04,8례초발치료NR조분별위21.62±6.50화1.38±0.02,삼조간Emax화slope차이균유통계학의의（P치균＜0.05）；초발치료CR조적Emax급slope 치균저우초발미치료조화인발치료NR조（P치균＜0.05）；초발미치료조Emax급slope치균저우초발치료NR조，단차이우통계학의의(P＞0.05)。47례AL환자가골골수적Emax치여골수상원시세포비례(25.6±4.2)％정정상관(r ＝0.501,P＜0.05)，여slope치우상관성(r＝0.235,P＞0.05)。결론 DCE-MRI시평고AL환자골수침윤미순배혈류동역학적유효방법，가망위AL환자예후평개급료효감측제공유개치적신식。
Objective Using dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) to evaluate the hemodynamic perfusion characteristics of bone marrow infiltration in patients with acute leukemia (AL). Methods Forty-seven patients with AL received coronal pelvic T1WI DCE-MRI with fast low angle shot (FLASH) sequence. Among them, 25 were initial onset untreated (IOU) patients, 22 were treated AL patients, including 14 with complete remission (CR) and 8 with non-remission ( NR). The hemodynamic perfusion parameters including maximum percentage of enhancement ( Emax ) and slope were determined based on enhancement-time curves ( ETCs ) of iliac and lumbar vertebra. The proportion of marrow myeloblasts was recorded. For all patients, quantitative perfusion parameters of bone marrow infiltration in ilium were compared with those in lumbar. The values of Emax and ES were compared among IOU,CR and NR patients. Correlations between perfusion parameters and histopathological results were assessed. Results In all the 47 patients, the Emax values of bilateral iliac bone marrow ( 15.70 ± 7.06)were slightly higher than that of lumbar bone marrow ( 11. 28 ± 5.52 ), and the difference was statistically significant (P ＜0. 01 ). There was no significant difference in the slop value between bilateral iliac bone marrow (0. 82 ± 0. 12 ) and lumbar bone marrow (0. 80 ± 0. 09 ) ( P ＞ 0. 05 ). In the 25 untreated patients,the Emax and slop values were 17. 15 ± 5.75 and 0. 98 ± 0. 13, respectively; in the 14 CR patients, they were 8. 76 ±3.93 and 0. 26 ± 0. 04, respectively, and in the 8 NR patients, they were 21.62 ± 6. 50 and 1. 38 ± 0. 02, respectively. There was significant difference in the Emax and slop values among the three groups (P＜0. 05). Compared with IOU and NR patients, both the Emax and slop values decreased significantly in iliac bone marrow of AL patients with CR (P ＜ 0. 05 ). There was no significant difference between IOU and NR patients ( P ＞ 0. 05 ). A significant positive correlation was found between Emax value of iliac bone marrow and the proportion of marrow myeloblasts ( r ＝0. 501 ,P ＜0. 05 ). There was a negative correlation between slop value of iliac bone marrow and the proportion of marrow myeloblasts ( r ＝0. 235 ,P ＞0.05). ConclusionsDCE-MRI can be used for evaluating the hemedynamic characteristics of microcirculation of bone marrow infiltration in patients with AL, which can provide useful information in evaluating prognosis and monitoring therapeutic effect.
