全身DWI在多发性骨髓瘤骨病评估中的作用  

The Role of Whole Body DWI in the Evaluation of Bone Disease in Multiple Myeloma

作　　者：谢妍 惠友友 姚飞荣[3] 胡春洪[3] 颜灵芝[1] 吴德沛[1] 傅琤琤[1] XIE Yan;HUI You-You;YAO Fei-Rong;HU Chun-Hong;YAN Ling-Zhi;WU De-Pei;FU Chenen(The First Affiliated Hospital of Soochow University National Clinical Research Center for Hematologic Diseases Suzhou,Jiangsu Institute of Hematology Key Laboratory of Thrombosis and Hemostasis of Ministry of Health,State Key Laboratory of Radiation Medicine and Protection,Soochow University Suzhou 215000,Jiangsu Province,China;Wuxi Woman and Enfants Care Hospital Wuxi 214002,Jiangsu Province,China;The First Affiliated Hospitalof Soochow University,Institute of Imaging Medicine,Soochow University,Suzhou 215000 Jiangsu Province,China)

机构地区：[1]苏州大学附属第一医院,国家血液系统疾病临床医学研究中心,江苏省血液研究所,国家卫生健康委员会血栓与止血重点实验室,放射医学与辐射防护国家重点实验室(苏州大学),江苏苏州215000 [2]无锡市妇幼保健院,江苏无锡214002 [3]苏州大学附属第一医院,苏州大学影像医学研究所,江苏苏州215000

出　　处：《中国实验血液学杂志》2022年第2期501-505,共5页Journal of Experimental Hematology

摘　　要：目的:探讨初诊症状性多发性骨髓瘤(MM)患者DWI检查的ADC值变化特征及其与R-ISS分期的相关性。方法:回顾性分析2016年6月至2019年6月于苏州大学附属第一医院接受全身DWI检查的初诊症状性MM患者148例的资料,另选取年龄匹配的健康人30例作为对照,比较正常对照、DWI-和DWI+组3组人群的ADC值差异,并进一步研究MM患者的ADC值与R-ISS分期的相关性。结果 :DWI+组患者的浆细胞百分比高于DWI-组。DWI+组患者的椎骨、胸骨、肋骨、上肢带骨、下肢带骨ADC值高于DWI-和正常对照组,DWI-组各部位ADC值均高于正常对照组。临床R-ISSⅢ期患者的胸骨、肋骨、上肢带骨ADC值高于临床R-ISSⅠ和Ⅱ期患者的ADC值,而R-ISSⅠ期和Ⅱ期患者组之间无统计学差异。R-ISS分期Ⅰ-Ⅲ期患者的其他骨部位如椎骨、下肢带骨ADC值均无明显统计学差异。结论:MM患者DWI+和高肿瘤浸润有关。DWI+组ADC值高于DWI-组,DWI-患者骨质ADC值仍高于正常者,且ADC值与R-ISS分期存在一定的相关性。Objective: To explore the characteristics of ADC value changes in DWI of newly diagnosed symptomatic MM patients and its correlation with R-ISS stage. Methods: The data of 148 newly diagnosed symptomatic MM patients treated by whole-body DWI scan at The First Affiliated Hospital of Soochow University from June 2016 to June 2019 were selected and retrospectively analyzed and 30 cases of age-matched healthy people were selected as controls. The differences of ADC values between the patients in normal control group, DWI-group and DWI+ group were compared, and the relationship between ADC values and R-ISS stage in MM patients was compared. Results: The plasma cell percentage of the patients in DWI+ group was higher than those in DWI-group. ADC values of vertebra, sternum, rib, pectoral girdle, pelvic girdle of the patients in DWI+ group were significantly higher than those in DWI-group and normal control group. The ADC values of each part of the patients in DWI-group were higher than those in normal control group. ADC values of sternum, rib and pectoral girdle in the patients at R-ISS stage III were higher than those at R-ISS stage I and II, while, there was no statistical difference between R-ISS stage I and II groups. And there was no significant difference in ADC values of other bone parts such as vertebra and pelvic girdle in patients at R-ISS stage Ⅰ-Ⅲ. Conclusion: DWI+ in MM patients is related to higher tumor invasion. The ADC values of the DWI+ group are higher than those of the DWI-group;the bone ADC values of the DWI-patients are still higher than the normal ones. And there is a certain relationship between ADC value and R-ISS stage.

关 键 词：多发性骨髓瘤 全身弥散加权成像 表观扩散系数 R-ISS分期 

分 类 号：R733.3[医药卫生—肿瘤]