WB-DWI在初诊多发性骨髓瘤诊断及疗效评估中的应用价值  

Application Value of WB-DWI in the Diagnosis and Efficacy Evaluation of Newly-diagnosed Multiple Myeloma

作　　者：李鹏[1] 王国旗 LI Peng;WANG Guo-qi(Department of Orthopaedics,First Affiliated Hospital of Nanyang Medical College,Nanyang 473000,Henan Province,China)

机构地区：[1]南阳医学高等专科学校第一附属医院骨科,河南南阳473000

出　　处：《中国CT和MRI杂志》2021年第3期148-150,170,共4页Chinese Journal of CT and MRI

摘　　要：目的探讨磁共振全身弥散加权成像(WBDWI)在初诊多发性骨髓瘤(MM)诊断及疗效评估中的应用价值。方法回顾性分析我院2013年1月至2017年9月期间收治的82例M M的临床病例资料及其治疗前后进行WB-DWI检查的影像学资料。结果 WB-DWI阳性检出率为98.78%(81/82),经WB-DWI确定的溶骨病变为96.43%(54/56);WB-DWI诊断ISS分期准确率为95.12%(78/82),WB-DWI诊断ISSⅠ期灵敏度为80.00%、特异度为96.10%、准确度95.12%,kappa值为0.641;WB-DWI诊断ISSⅡ期灵敏度为90.48%、特异度为98.36%、准确度为96.3 4%,kappa值为0.902;WB-DWI诊断ISSⅢ期灵敏度为98.21%、特异度为100.00%、准确率为98.78%,kappa值为0.972;WB-DWI诊断MM临床分型准确率为79.27%(65/82),WB-DWI诊断IgG型灵敏度为83.33%、特异度为88.46%、准确度为86.59%、kappa值为0.713,WB-DWI诊断IgA型灵敏度为73.91%、特异度为89.83%、准确度为85.37%、kappa值为0.637,WB-DWI诊断IgD型灵敏度为60.00%、特异度为10.00%、准确度为97.56%、kappa值为0.738,WB-DWI诊断轻链型灵敏度为83.33%、特异度为91.38%、准确度为89.02%、kappa值为0.738。82例MM经过诱导治疗后复查WB-DWI,疗效评估≥SD的67例检查显示最大病灶直径较治疗前明显缩小(P<0.05),疗效评估≥VGPR治疗后的最大病灶的中位表观弥散系数(ADC)值较治疗前明显升高(P<0.05)。结论 WB-DWI在MM诊断及分期中具有重要的意义,在一定程度上能够评估治疗的效果。Objective To explore the application value of whole body diffusion weighted magnetic resonance imaging(WB-DWI) in the diagnosis and efficacy evaluation of newly-diagnosed multiple myeloma(MM).Methods The clinical data of 82 cases of MM admitted to our hospital from January 2013 to September 2017 and the imaging data before and after WB-DWI treatment were retrospectively analyzed.Results The positive detection rate of WB-DWI was 98.78%(81/82),and the osteolytic lesion confirmed by WB-DWI was 96.43%(54/56).The accuracy rate of WB-DWI diagnosis of ISS staging was 95.12%(78/82),and the sensitivity,specificity,accuracy and kappa value of WB-DWI diagnosis of ISS stage I were 80.00%,96.10%,95.12%,and 0.641.The sensitivity,specificity,accuracy and kappa value of WB-DWI diagnosis of ISS stage II were 90.48%,98.36%,96.34%,and 0.902.The sensitivity,specificity,accuracy and kappa value of WB-DWI diagnosis of ISS stage Ⅲ were 98.21%,100.00%,98.78%,and 0.972.The accuracy rate of WB-DWI diagnosis of MM clinical classification was 79.27%(65/82),and the sensitivity,specificity,accuracy and kappa value of WB-DWI diagnosis of IgG type were 83.33%,88.46%,86.59%,and 0.713,and the sensitivity,specificity,accuracy and kappa value of WB-DWI diagnosis of IgA type were 73.91%,89.83%,85.37%,and 0.637,and the sensitivity,specificity,accuracy and kappa value of WB-DWI diagnosis of IgD were 60.00%,10.00%,97.56% and0.738,and the sensitivity,specificity,accuracy and kappa value of WB-DWI diagnosis of light-chain type were 83.33%,91.38%,89.02%,and 0.738.82 cases of MM were reviewed by WB-DWI after induction therapy,and 67 cases of efficacy evaluation ≥ SD showed that the maximum lesion diameter was significantly smaller than that before treatment(P<0.05),and the median apparent diffusion coefficient(ADC) of maximum lesion after efficacy evaluation ≥VGPR treatment was increased significantly compared with that before treatment(P<0.05).Conclusion WB-DWI has important significance in the diagnosis and staging of MM,and it can evaluate the tre

关 键 词：磁共振全身弥散加权成像 多发性骨髓瘤 分期 中位表观弥散系数 疗效 

分 类 号：R445.2[医药卫生—影像医学与核医学] R733.3[医药卫生—诊断学]