全身磁共振扩散加权成像对多发性骨髓瘤的诊断价值  

Diagnostic value of whole-body diffusion weighted imaging in multiple myeloma

作　　者：王明 刘莹 王亚丽[1] 张伟[2] 崔凤珍[3] 李玉清[1] WANG Ming;LIU Ying;WANG Ya-li;ZHANG Wei;CUI Feng-zhen;LI Yu-qing(Department of CT and MRI, the Third Hospital of Hebei Medical University, Shijiazhuang 050051, China;Department of Radiology, the Third Hospital of Hebei Medical University, Shijiazhuang 050051, China;Department of MRI, the Second Hospital of Shijiazhuang City, Hebei Province, Shijiazhuang 050051, China)

机构地区：[1]河北医科大学第三医院CT/MRI室,河北石家庄050051 [2]河北医科大学第三医院放射科,河北石家庄050051 [3]河北省石家庄市第二医院核磁室,河北石家庄050051

出　　处：《河北医科大学学报》2022年第2期198-202,共5页Journal of Hebei Medical University

基　　金：河北省重点研发计划自筹项目(172777134)。

摘　　要：目的探讨全身磁共振扩散加权成像(whole body diffusion weighted imaging,WB-DWI)对多发性骨髓瘤的诊断价值。方法收集首次确诊的多发性骨髓瘤患者31例为试验组,另选取健康者98例为对照组,治疗前对其行WB-DWI检查并测量病变部位的表观扩散系数(apparent diffusion coefficient,ADC)值,分析ADC值与临床化验指标的相关性。结果在DWI(b=800 s/mm^(2))图像上,骨髓瘤病变呈高信号,呈斑点或斑片状局灶或弥漫分布,在ADC图上呈低信号,有3例出现髓外病变。骨髓瘤全身各部位ADC均值为(0.77±0.21)×10^(-3)mm^(2)/s,各部位ADC均值与正常骨髓ADC值差异有统计学意义(P<0.05)。髂骨ADC均值与骨髓瘤细胞百分比呈正相关(r_(s)=0.560,P=0.008),全身各部位ADC均值与血红蛋白呈负相关(r_(s)=-0.490,P=0.011);与血β_(2)-微球蛋白(β_(2)-microglobulin,β_(2)-MG)、尿β_(2)-MG、C反应蛋白呈正相关(r_(s)=0.557、0.517,P=0.05、0.004、0.014)。结论WB-DWI用于多发性骨髓瘤的诊断及监测有重要价值,应当将其作为首诊骨髓瘤患者的常规影像检查方法。Objective To explore the diagnostic value of whole-body diffusion weighted imaging(WB-DWI)in multiple myeloma.Methods In total,31 patients with multiple myeloma diagnosed initially were collected as the experimental group,and 98 healthy subjects were selected as the control group.Before treatment,WB-DWI was performed,the ADC value of the lesion was measured,and the correlation between ADC value and clinical laboratory indexes was analyzed.Results The lesions showed high signal intensity with focal or diffused distribution on DWI(b=800 s/mm^(2))images and low signal intensity on the ADC maps.Extramedullary lesions were found in 3 cases.The mean ADC value of the lesions in the whole body was(0.77±0.21)×10^(-3) mm^(2)/s and was significantly different from that of the normal bone marrow(P<0.05).The mean ADC value of the lesions in iliac bone was positively correlated with the percentage of myeloma cells(r_(s)=0.560,P=0.008).The mean ADC value of the lesions in the whole body was negatively correlated with the blood HBG(r_(s)=-0.490,P=0.011),and positively correlated with the serum and urineβ_(2)-MG and serum CRP(r_(s)=0.557,0.517,P=0.05,0.004,0.014).Conclusion WB-DWI has an important value in the diagnosis and monitoring of initially diagnosed multiple myeloma,which,therefore,should be used as a routine imaging method for patients initially diagnosed with multiple myeloma.

关 键 词：多发性骨髓瘤 全身磁共振扩散加权成像 ADC值 

分 类 号：R733.3[医药卫生—肿瘤]