恶性血液肿瘤脊柱骨髓弥漫性浸润的动态对比增强MR灌注成像

Dynamic Contrast-enhanced MR Perfusion imaging of Diffuse Spinal Bone Marrow Infiltration in Patients with Hematological Malignancies

目的评价动态对比增强MR灌注成像对恶性血液肿瘤脊柱骨髓弥漫性浸润性病变的诊断价值。资料与方法经骨髓组织活检确诊的恶性血液肿瘤26例和20例正常对照者行腰椎动态对比增强MR灌注成像检查。计算峰值增强百分率(Emax)、增强斜率(ES)和到达峰值时间(TTP)。结果脊柱骨髓弥漫性恶性浸润组与正常对照组间的Emax、ES和TTP均具有显著差异(P<0.01)。骨髓轻度浸润和中度浸润之间的Emax、ES和TTP均具有显著差异(P<0.05)。骨髓轻度浸润和重度浸润之间的Emax、ES和TTP均具有显著差异(P<0.01)。骨髓中度浸润和重度浸润之间的Emax、ES和TTP无显著差异(P>0.05)。Emax、ES和骨髓浸润程度之间具有正相关性(P<0.01),TTP和骨髓浸润程度之间具有负相关性(P<0.01)。结论动态对比增强MR灌注成像可以判断恶性血液肿瘤是否出现脊柱骨髓弥漫性浸润,灌注参数可以反映骨髓肿瘤细胞浸润程度。

Objective To evaluate the role of dynamic contrast - enhanced MR perfusion imaging in the diagnosis of diffuse spinal bone marrow infiltration in patients with hematological malignancies. Materials and Methods Dynamic contrast - enhanced MR perfusion imaging of the lumbar spine was performed in 26 patients with diffuse bone marrow infiltration by hematological malignancies confirmed by biopsy and 20 normal subjects. Peak enhancement percentage （Emax） , enhancement slope （ES） , and time to peak （TTP） were measured. Results There was a significant difference in Emax, ES, and TIP values between the spinal bone marrow infiltration group and normal control group （P 〈0.01 ）. Emax, ES and TrP values were significantly different between the mild bone marrow infiltration group and the moderate bone marrow infiltration group （ P 〈 0.05 ）. E ES and TrP values were also significantly different between the mild bone marrow infiltration group and the severe bone marrow infihration group （P 〈 0. 01 ）. However, There was no significant difference in Emax, ES, and TTP values between the moderate bone marrow infiltration group and severe bone marrow infiltration group （ P 〉 0.05 ）. There was a positive correlation between Emax and ES values and the degree of bone marrow infiltration （P 〈 0.01 ）. A negative correlation was found between TIP values and the degree of bone marrow infiltration （ P 〈 0. 01 ）. Conclusions Dynamic contrast - enhanced MR perfusion imaging of the spine could demonstrate diffuse bone marrow infiltration of hematological malignancies, and perfusion imaging parameters could reflect the degree of bone marrow infiltration.