MRI常规序列信号比及ADC值评估多发性骨髓瘤诊断效能的临床应用研究  

Clinical application of the diagnostic efficacy of MRI routine sequence signal ratio and ADC value in evaluating multiple myeloma

作　　者：刘斌 郭静 叶敏[1] 眭云 肖瑶 LIU Bin;GUO Jing;YE Min;SUI Yun;XIAO Yao(Department of Radiology,People s Hospital of Chongzhou City,Chongzhou 611200;Medical Imaging Key Laboratory of Sichuan Province,Department of Radiology,Affiliated Hospital of North Sichuan Medical College,Nanchong 637000,Sichuan,China)

机构地区：[1]崇州市人民医院放射科,四川崇州611200

出　　处：《川北医学院学报》2025年第3期331-335,共5页Journal of North Sichuan Medical College

基　　金：四川省医学科研课题计划(S20075)。

摘　　要：目的:探讨MRI常规序列信号比及ADC值对多发性骨髓瘤(MM)的诊断效能及临床应用价值。方法:选取35例初诊MM患者为MM组;43名健康志愿者为对照组,两组均行腰椎MRI常规序列(T1WI、T2WI、SPAIR)及DWI扫描。比较MM组患者(包括MM各亚组不同分期)和对照组、MM亚组各序列信号比及ADC值;采用受试者工作特征(ROC)曲线分析灵敏度及特异度,获取ADC截点值,并比较ROC曲线下面积(AUC)。结果:MM组患者T1WI信号比低于对照组(P<0.05),敏感度及特异度分别为0.97和0.93;SPAIR信号比高于对照组(P<0.05),敏感度及特异度分别为0.68和0.97;ADC值高于对照组(P<0.05),敏感度及特异度分别为0.93和0.95;ADC值的截断值为0.52(×10^(-3)mm^(2)/s)。AUC值:ADC值>T1WI信号比>SPAIR信号比,且成对分析显示,T1WI信号比与ADC值比较,差异无统计学意义(P>0.05),二者评价效能相当,均优于SPAIR信号比,差异有统计学意义(P<0.05)。结论:T1WI信号比及ADC值具有较高的敏感度及特异度,且诊断效能优于SPAIR信号比,ADC值>0.52时有明显差异,联合应用T1WI及ADC值有助于MM的诊断。Objective:To explore the diagnostic efficacy and clinical value of the signal ratio of MRI conventional sequences and the apparent diffusion coefficient(ADC) value in multiple myeloma(MM).Methods:35 patients with newly diagnosed MM and 43 normal controls were recruited.Lumbar MRI conventional sequences(T1WI,T2WI,SPAIR) and DWI scans were performed.The differences in sequence signal ratios and ADC values between MM(including subgroups of MM at different stages) and the normal control group were compared.Sensitivity and specificity were analyzed using ROC curves.The ADC cutoff value was obtained.The differences in the area under the ROC curves were compared.Results:The T1WI signal ratio of the MM group was lower than that of the normal control group(P<0.01),with the sensitivity and specificity of 0.97 and 0.93 respectively.The SPAIR signal ratio was higher than that of the normal control group(P<0.01),with the sensitivity and specificity of 0.68 and 0.97 respectively.The ADC value was higher than that of the normal control group(P<0.05),with the sensitivity and specificity of 0.93 and 0.95 respectively.The ADC cutoff value was 0.52(×10^(-3)mm^(2)/s).The area under the ROC curve(AUC) was:ADC value > T1WI signal ratio > SPAIR signal ratio.Pairwise analysis of AUC showed that there was no statistically significant difference between the T1WI signal ratio and the ADC value(P>0.05),and both had the same evaluation efficacy,which was superior to that of the SPAIR signal ratio,and the difference was statistically significant(P<0.05).Conclusion:The T1WI signal ratio and ADC value have high sensitivity and specificity,and their diagnostic efficacy is better than that of the SPAIR signal ratio.There is a significant difference when the ADC value is higher than 0.52.The combined application of T1WI and ADC value is conducive to the diagnosis of MM.

关 键 词：多发性骨髓瘤 磁共振信号比 表观弥散系数 诊断效能 

分 类 号：R733.3[医药卫生—肿瘤]