小儿贫血及白血病骨髓的脂肪抑制(STIR)MRI  

Fat Suppression MRI (STIR) of Bone Marrow in Children Anemia and Leukemia

作　　者：叶滨滨[1] 陈丽英[1] 陈培青[1] 董文翰[1] 杨丽梅[1] 

机构地区：[1]中国医科大学第二临床学院

出　　处：《中国医学计算机成像杂志》1998年第3期192-194,共3页Chinese Computed Medical Imaging

摘　　要：目的：本文试就ＳＴＩＲ法对小儿贫血及白血病的骨髓改变的ＭＲＩ诊断价值加以讨论。材料和方法：本组病例包括经骨穿检查的贫血患儿１２例（缺铁性贫血３例，巨细胞贫血２例，再障贫血７例）；白血病１２例。同年龄对照组２０例。扫描方法：ＳＴＩＲ序列，ＴＲ＝１５００ｍｓｅｃ，ＴＩ＝１００ｍｓｅｃ，ＴＥ＝３０ｍｓｅｃ；部位：腰骶部及胸腰段椎体的矢状位。结果：正常组在ＳＴＩＲ序列中骨髓信号为边缘高信号，中心低信号，中心低信号区随年龄的增加扩大和明显，是脂肪髓化的部位，边缘的高信号区为造血细胞存在部位。缺铁性贫血的３例和巨细胞贫血的２例均可见骨髓边缘的高信号区明显扩大，但仍保持正常的分布状态；再障贫血的７例出现骨髓边缘的高信号区消失，但１例骨髓低信号中可见星点状高信号，为残存的造血组织。１２例白血病病例中１０例可见骨髓信号明显升高且信号混杂，中心区亦可见高信号，失去了正常的分布；另２例化疗后的病例，骨髓信号虽高而不均，但中心部的低信号已见。Purpose:This study is to evaluate the clinical value of the diagnosis of anemia and leukemia on MRI.Materials and Methods:12 cases of anemia confirmed by osseous punctures(Hypoferric anemia in 3 cases,macrocytic anemia in 2 cases,aplastic anemia in 6 cases)and another 12 cases of leukemia were included in this study and 20 normal children of the same age as control group.STIR images were obtained with a TR of 1500 msec,TI of 100 msec,TE of 30 msec.The location of scanning was at the lumbosacral and thoracolumbar spine marrow.Results:Peripheral high intensity and central low intensity of bone marrow appeared on STIR images in the normal children group.The central part of low intensity became more extensive and conspicuous with the increase of age and adipose myelopoiesis,whereas the peripheral part of high intensity was corresponded to the active hematopoietic tissue.Apparent high intensity at the margin of bone marrow with normal configuration was present in all of 3 cases of hypoferric anemia and 2 cases of macrocytic anemia,while absence of high intensity at the margin of bone marrow was present in 7 cases of aplastic anemia,mottled high intensity in 1 of 7 cases caused by the residual hematopoietic tissue. Miscellaneous high intensity of bone marrow appeared in 10 of 12 cases of leukemia,in which high intensity was present in the central part with abnormal configuration.Inhomogeneous high intensity of bone marrow combining with central low intensity appeared in 2 of 12 cases resulted of chemotherapy.Conclusion:STIR method plays an important role in the evaluation of myelopathy of children wiih anemia and leukemia

关 键 词：贫血 白血病 MRI 儿童 骨髓 脂肪抑制 

分 类 号：R733.7[医药卫生—肿瘤]