多发性骨髓瘤全身磁共振T_2WI成像与类PET成像价值的对比研究

Comparative research of whole-body MRI imaging and pet-like imaging in multiple myeloma

目的进一步研究多发性骨髓瘤(multiple myeloma,MM)的全身类PET成像特点,并与T_2WI成像相比较以探讨二者发现MM病灶的敏感性及临床价值。方法对45例初发的经骨髓穿刺或临床综合资料确诊的患者采用我院Siemens 3.0T磁共振进行全身T_2WI和类PET检查,对其T_2WI与类PET表现和阳性率进行对照研究。结果 MM在T2FS依据病灶信号增高表现分为以下各型,即正常型、"盐和胡椒"型、局灶型、弥漫型、局灶和弥漫混合型。MM依据病灶浸润程度在类PET上分为四型,即正常型、轻度浸润型、中度浸润型、重度浸润型。类PET发现病变阳性率较高。结论磁共振类PET成像对MM的敏感性及临床价值均高于T_2WI成像,有助于临床医生了解MM患者骨髓浸润情况,但类PET的特异性较差且同时存在诸多假阳性。将类PET检查加入Durie/Salmon plus分期标准可以提高临床分期以及对生存期预测的准确性。

Objective To further research the pet-like images of whole-body magnetic resonance of multiple myeloma. And in contrast with T2-WI in order to discuss their sensitivity and clinical value. Methods 45 multiple myeloma patients were enrolled. Pathological or clinical proofs of multiple myeloma were obtained in all cases. We conducted contrast research of manifestations and positive rates. Results MM can be divided into normal, focal, diffuse, focal and diffuse, ＂salt-and-pepper＂ patterns in T2 - WL 45 cases were classified as normal type, mildly infiltrating type, moderately infiltrating type, severely infiltrating type in pet-like imaging. The positive rate of pet-like imaging was high. Conclusion The pet-like sensitivity and clinical value of MM is higher than T2-WI, the pet-like imaging can contribute to realise bone marrow infiltration of MM. But the specificity of pet-like is worse than T2-WI. The pet - like imaging can improve clinical stages and prediction of life expectancy in the case of adding pet-like imaging into Durie/Salmon plus staging system.