3.0T全身不同成像序列组合对淋巴瘤浸润骨髓的评估价值  

Evaluation value of 3.0T whole body magnetic resonance imaging in bone marrow involvement of malignant lymphoma

作　　者：陈晓晖 龚永驰[2] 聂芳[2] 宋慧慧[3] 施海彬[1] CHEN Xiaohui;GONG Yongchi;NIE Fang;SONG Huihui;SHI Haibin(Department of Radiology,the First Clinical Medical College of Nanjing Medical University,Nanjing 210029,China;Department of Radiology,Zhongda Hospital,Southeast University,Nanjing 210009,China;Department of Hematology,Zhongda Hospital,Southeast University,Nanjing 210009,China)

机构地区：[1]南京医科大学第一临床医学院影像科,江苏南京210029 [2]东南大学附属中大医院放射科,江苏南京210009 [3]东南大学附属中大医院血液科,江苏南京210009

出　　处：《现代医学》2018年第11期1238-1243,共6页Modern Medical Journal

摘　　要：目的:探讨3. 0T磁共振成像中联合应用常规MRI T2WI、STIR、T1-m Dixon和WBDWI 4种检查技术组合方案行全身成像对淋巴瘤浸润骨髓的临床诊断价值。方法:收集东南大学附属中大医院血液科2016年12月至2018年6月收治的62例恶性淋巴瘤患者,使用Philips Ingenia II 3. 0T磁共振扫描仪,对患者行冠状位常规T2WI、STIR、T1-m Dixon及横断位的WBDWI检查。对全身磁共振成像的4组序列进行以下5种检查不同的组合方案,即仅WBDWI技术(组合一),T2WI联合WBDWI技术(组合二),STIR联合WBDWI技术(组合三),T1-m Dixon联合WBDWI技术(组合四),以及T2WI、STIR、T1-m Dixon联合WBDWI技术(组合五)。以淋巴瘤浸润骨髓确诊依据为金标准,评价上述5组检查方案对恶性淋巴瘤(ML)浸润骨髓的诊断效能。采用SPSS 18. 0统计软件,行配对卡方(McNemar)检验以评价任两个方案间差异有无统计学意义。结果:62例疑似淋巴瘤浸润骨髓的患者,确诊38例。对各组合方案经Mc Nemar检验两两比较结果显示,组合四和组合五之间对ML浸润骨髓诊断的敏感性和准确率,较前3种方案差异有统计学意义(P <0. 000 1),两者之间对ML浸润骨髓诊断的特异性也存在显著差异(P <0. 05)。结论:对临床疑似淋巴瘤浸润骨髓者,采用T2WI、STIR、T1-m Dixon联合WBDWI技术进行全身磁共振检查,大大提高病灶的检出率和准确率,能够指导临床及时调整诊疗方案,具有较高的临床应用前景。Objective:To explore the clinical value of 3.0T magnetic resonance whole-body imaging in the bone marrow infiltration of lymphoma combined with conventional MRI T2WI,STIR,T1-mDixon and WBDWI. Methods:62 patients with malignant lymphoma were collected.These patients were admitted to the Department of Hematology in Zhongda Hospital from December 2016 to June 2018.Using the Philips Ingenia II 3.0T magnetic resonance scanner,the coils were used to perform the patient's coronal scan of conventional T2WI,STIR and T1- mDixon sequences,and transverse WBDWI scan.Four sequences for whole-body magnetic resonance imaging (T2WI,STIR,T1-mDixon,WBDWI)were combined in the following five different combinations:Combination 1, only using WBDWI technology; Combination 2,using T2WI combined with WBDWI technology; Combination 3, using STIR combined with WBDWI technology; Combination 4,using T1-mDixon combined with WBDWI technology; Combination 5,using T2WI,STIR and T1-mDixon combined with WBDWI technology.According to the gold standard for the diagnosis of lymphoma bone marrow infiltration,the evaluation scores compared with diagnostic results under different imaging protocols and histopathology results were used to evaluate the diagnostic efficacy of the above five examination combinations for bone marrow infiltration of malignant lymphoma(ML).The Mcnemar test was used.Results:The analyzing results of lymphoma bone marrow infiltration through different combinations of T1-mDixon,T2WI,STIR and WBDWI scanning showed:Of the 62 patients with suspected lymphoma bone marrow infiltration,35 patients were diagnosed by bone marrow aspiration or biopsy pathology.The results of the McNemar tests between the two groups of the imaging combinations showed that the sensitivity and accuracy of Combination 4 and Combination 5 in the diagnosis of ML bone marrow infiltration were significantly different from the other combinations(P<0.000 1),but there was a statistically significant difference between Combination 4 and Combination 5 in the diagnosis spe

关 键 词：恶性淋巴瘤 mDixon序列 短时反转恢复序列 全身扩散加权成像 

分 类 号：R733.4[医药卫生—肿瘤] R730.44[医药卫生—临床医学]