不同时期急性白血病患儿骨髓MRI表现分析

Analysis of Bone Marrow MRI Findings in Children with Acute Leukemia at Different Stages

目的分析急性白血病(acute leukemia,AL)初发患儿及完全缓解患儿骨髓磁共振成像(MagneticResonance Imaging,MRI)表现及增强MRI评估AL的临床意义。方法收集我院2013年2月-2018年10月期间收治的58例AL患儿为研究对象,初发者36例(初发组),治疗后完全缓解者22例(完全缓解组),另选取同期体检健康的志愿者30例作为对照组,均进行常规MRI扫描和增强MRI扫描,比较各组患儿MRI扫描特征,最大强化率(maximum percentage of enhancement,Emax)及强化斜率(slope)。结果与对照组相比,初发组患儿T1WI表现为腰椎、髂骨信号明显降低,完全缓解组T1WI表现为腰椎、髂骨信号有所增高,出现条状高信号,与对照组相似。三组T2WI均表现为腰椎、髂骨均匀等信号。各组骨髓浸润Emax和Slope差异均有统计学意义(P<0.05),Emax和Slope值从高到底依次为初发组、完全缓解组和对照组。结论不同时期AL患儿骨髓MRI影像特征不同,增强MRI扫描有助于提高AL诊断准确性。

Objective To analyze the MRI manifestations of bone marrow in children with acute leukemia(AL) and those with complete remission, and to evaluate the clinical significance of acute leukemia with enhanced MRI. Methods A total of 58 children with AL admitted to the hospital from February 2013 to October 2018 were enrolled. The number of incipient patients was 36 cases(incipient group). The number of complete remission patients after treatment was 22 patients(complete remission group). The other 30 healthy volunteers undergoing physical examination in the same period were selected as the control group. All of them underwent routine MRI scan and enhanced MRI scan. The MRI scan features, maximum percentage of enhancement(Emax) and slope of the enhancement in each group were compared. Results Compared to the control group, the T1 WI showed a significant decrease signals in lumbar spine and ilium in the incipient group. The T1 WI in the complete remission group showed enhanced lumbar spine and ilium signals. And there was a strip-like high signal, which was similar to that in the control group. T2 WI in the three groups showed equal signs of lumbar spine and ilium. There were significant differences in Emax and Slope of bone marrow infiltration in the three groups(P<0.05). Arranging the Emax and Slope values from high to low, the corresponding order was the incipient group, the complete remission group and the control group. Conclusion The characteristics of bone marrow MRI in children with AL in different periods are different. Enhanced MRI scan is helpful to improve the diagnosis accuracy of AL.