CAJ | 학술논문

目的：分析小儿急性白血病在初始发病、化疗缓解后骨髓的MRI平扫及波谱特征。方法35例急性白血病患儿行MR检查，其中7例在初始发病、完全缓解前后2次行MRI检查（即初发组26例，完全缓解组16例），并以30例同年龄段健康志愿者为对照组，均行骨髓MRI及1H-MRS扫描，并计算兴趣区骨髓脂肪相对含量（FF%）。结果 MR平扫时，初发组骨髓在T1WI表现为均匀的信号降低，在STIR序列呈弥漫性信号增高，缓解组骨髓在T1WI较初发组信号增高，在STIR序列则信号减低。MRS显示，初发组脂峰消失，完全缓解组脂峰重新出现，较对照组均有变化。除缓解组、对照组间髂骨的FF%无显著性差异外（P＞0.05），其余组间第4腰椎、髂骨的FF%值均有统计学差异（P＜0.05）。初发组、完全缓解组组内第4腰椎与髂骨之间的FF%值无统计学差异。初发组和缓解组第4腰椎、髂骨FF%值与骨髓原幼细胞百分比（B%）之间无相关性（r＝0）。结论小儿急性白血病在初始发病、化疗缓解后骨髓的MRI及MRS表现具有不同特征。
목적：분석소인급성백혈병재초시발병、화료완해후골수적MRI평소급파보특정。방법35례급성백혈병환인행MR검사，기중7례재초시발병、완전완해전후2차행MRI검사（즉초발조26례，완전완해조16례），병이30례동년령단건강지원자위대조조，균행골수MRI급1H-MRS소묘，병계산흥취구골수지방상대함량（FF%）。결과 MR평소시，초발조골수재T1WI표현위균균적신호강저，재STIR서렬정미만성신호증고，완해조골수재T1WI교초발조신호증고，재STIR서렬칙신호감저。MRS현시，초발조지봉소실，완전완해조지봉중신출현，교대조조균유변화。제완해조、대조조간가골적FF%무현저성차이외（P＞0.05），기여조간제4요추、가골적FF%치균유통계학차이（P＜0.05）。초발조、완전완해조조내제4요추여가골지간적FF%치무통계학차이。초발조화완해조제4요추、가골FF%치여골수원유세포백분비（B%）지간무상관성（r＝0）。결론소인급성백혈병재초시발병、화료완해후골수적MRI급MRS표현구유불동특정。
Objective To evaluate the MRI and proton MR spectroscopy(1H-MRS)features of bone marrow at different stages of acute leukemia in children.Methods 35 patients with acute leukemia confirmed by bone marrow biopsies underwent MRI.Two MRI examinations were performed on 7 children at tumor presentation and remission resulting in 26 examinations at presentation,16 at remission with 30 healthy volunteers as control.The lipid-to-water ratios(LWRs)and relative fat content(FF%)were calculated. Results The bone marrow at presentation was homogeneously T1 hypointense and diffusely hyperintense on STIR-weighted MR images.At remission,the bone marrow was more hyperintense on T1- and isointense to slightly hyperintense on STIR-weighted images.On 1H-MRS,the lipid peak was absent at presentation and re-appeared in remission.The FF%of the left ilium between presentation and remission,between presentation and normal control,and the FF%of the L4 vertebra between different groups were significantly different(P<0.05).The FF%of ilium between remission and normal control was not significantly different(P>0.05). There was no correlation between percentage of immature cells and the FF%of L4 and ilium(r=0).Conclusions The bone marrow in children has different MRI and MRS characteristics at presentation and remission of acute leukemia.