DWI联合常规MRI在儿童急性白血病腰椎浸润中的诊断价值  

Diagnostic value of DWI combined with conventional MRI in diagnosis of lumbar infiltration in children with initial acute leukemia

作　　者：孙海燕 李荣品[1] 吴亚兰 焦祺[1] 王晶[1] 陈霞[1] 侯振洲[1] 阎玉彦[1] 张楠[1] SUN Haiyan;LI Rongpin;WU Yalan(Department of CT-MRI,Hebei Provincial Children’s Hospital,Hebei,Shijiazhuang 050031,China)

机构地区：[1]河北省儿童医院CT-磁共振科,石家庄市050031

出　　处：《河北医药》2022年第22期3405-3408,3412,共5页Hebei Medical Journal

基　　金：河北省科技计划项目(编号:182777152)。

摘　　要：目的研究儿童初发急性白血病腰椎MRI常规序列和扩散加权成像(DWI)的临床应用价值。方法收集2019年3月至2020年10月经临床骨髓穿刺细胞学确诊的初发白血病儿童51例为研究组,相应年龄组正常儿童30例为正常对照组,进行常规MRI及DWI扫描。根据T1WI像分析腰2~4椎体信号类型,同时测量椎体T1信号强度(ST1)、T2信号强度(ST2)、STIR信号强度(SSTIR)、DWI信号强度(SDWI)及ADC值,比较研究组与正常对照组间各研究指标的差异,并分析各指标与骨髓原幼细胞百分比(B%)之间的相关性。结果急性白血病腰椎椎体信号以Ⅰ型弥漫性低信号为主,与正常对照组比较差异有统计学意义(P=0.000)。急性白血病组各测量值在不同年龄组间差异无统计学意义(P>0.05)。正常对照组ST1、ST2在两年龄组间差异有统计学意义(P=0.013;P=0.019),≥6岁组高于0~5岁组(P<0.05)。白血病组较正常对照组椎体ST1及ST2减低,差异有统计学意义(P<0.05)。白血病组与正常对照组SDWI差异有统计学意义(t=4.177,P<0.05),ADC值差异无统计学意义(P=0.432)。白血病组ST1与SDWI之间呈负相关(r=-0.484,P<0.05),各测量值与骨髓原幼细胞百分比(B%)间无明显相关性(P>0.05)。结论初发急性白血病儿童腰椎骨髓T1WI信号弥漫性减低,DWI序列信号增高,能对儿童初发急性白血病骨髓进行定量分析,各序列信号强度与骨髓原幼细胞百分比(B%)之间无明显相关性。Objective To investigate the clinical application value of conventional sequences of MRI and diffusion weighted imaging(DWI)in diagnosis of lumbar infiltration in children with initial acute leukemia.Methods A total of 51 children patients with initial leukemia diagnosed by clinical bone marrow aspiration cytology in our hospital from March 2019 to Octoher 2020 were enrolled as research group,and 30 heathy children with corresponding age were enrolled as control group,and conventional MRI and DWI scans were performed.The signal type of lumbar 2~4 vertebrae was analyzed according to T1WI images,and vertebral T1 signal intensity(ST1),T2 signal intensity(ST2),STIR signal intensity(SSTIR),DWI signal intensity(SDWI)and ADC values were measured,and the differences in above indexes were observed and compared between the two groups.Moreover the correlation between each index and the percentage of bone marrow promyelocytes(B%)was analyzed.Results The signal of the lumbar vertebrae in patients with acute leukemia was predominantly typeⅠdiffuse low signal,and the difference was significant,as compared with that in control group(P<0.01).There were no significant differences in the measurement values in different age groups(P>0.05).There were significant differences in ST1 and ST2 in control group between the two age groups(P<0.05),which in≥6 years age group were significantly higher than those in 0~5 years age group(P<0.05).Compared with those in control group,the Vertebral ST1 and ST2 in research group were significantly decreased(P<0.05).There were significant differences in SDWI values between the two groups(P<0.05),however,there were no significant differences in ADC values between the two groups(P>0.05).Moreover there was a negative correlation between ST1 and SDWI in research group(P<0.05),but there was no significant correlation between each measurement value and the percentage of bone marrow promyelocytes(B%)(P>0.05).Conclusion The T1WI signal of the bone marrow of the lumbar spine in children with initial acute

关 键 词：急性白血病 骨髓 儿童 扩散加权成像 

分 类 号：R733.71[医药卫生—肿瘤]