急性白血病骨髓MRI定性及定量诊断价值.doc

急性白血病骨髓MRI定性及定量诊断价值 　摘要目的：通过观察急性白血病治疗前后骨髓的MRI表现和T1及对比度噪声比（CNR）的测定，对照临床、病理资料，探讨急性白血病骨髓MRI定性和定量诊断价值。材料与方法：选择经临床确诊为急性白血病的患者38例，缓解组25例，对照组35例进行MRI检查及T1值和对比度噪声比（CNR）的测定。结果：急性白血病T1WI ：治疗前组38例,腰骶椎、髂骨及股骨近段均表现为信号降低；化疗缓解组25例表现为不同程度的信号增高。 T2WI：38例治疗前组和25例化疗后组各椎体、髂骨、股骨上段呈等信号。外周血B%、骨髓B%、腰椎T1值、腰椎/皮下脂肪CNR、股骨骨髓/皮下脂肪CNR于急性白血病治疗前组与正常对照组、治疗前组与缓解组间的差异均有显著性（Plt;0.05），缓解组与正常对照组间的差异无显著性（Pgt;0.05），不同细胞类型间的差异无显著性（ Pgt;0.05）。腰椎T1值于不同性别、年龄组间的差异无显著性（ Pgt;0.05）。治疗前组骨髓B%与腰椎T1值、与腰椎/皮下脂肪CNR，外周血B%与腰椎T1值、与腰椎/皮下脂肪CNR及腰椎T1值与腰椎/皮下脂肪CNR 之间成直线相关（Plt;0.05）。结论：急性白血病的ＭＲＩ检查为一种无创性方法，MRI表现具有一定的特征性，在估计病情的严重程度及治疗效果的评价简便实用，为避免多次重复骨髓穿刺检查以及全面观察急性白血病骨髓浸润范围和程度有着重要的临床意义。 关键词：急性白血病磁共振成像（MRI） 诊断治疗 The Vale of MRI in acute leukemia naturally and quantitatively [Abstract]objectiveTo evaluate MRI diagnosis of bone narrow in acute leukemia by observing MRI appearance and calculating T1 value,CNR(ratio of contrast/noise) in patients before and after chemothrapy, contrasting to materials in clinic and pathology. Materials and methods Thirty-eight patients, with acute leukemia were examined.Twenty-five patients served as remission group. As control group ,35 healthy volunteers were performed MR examination with identical methods. Serial MR studies include observation of MRI character and measurement of T1 value and CNR in all patients. ResultOf all 38 cases of acute leukemia at the time of diagnosis compare with control group: Hypointense signal in T1WI by well-distribute were found in lumbosacral vertebral, iliac, and femur approaching. Isointense signal in T2WI was found in all cases we done. The signal intensity in T1WI tended to normal in all 25 remission cases of acute leukemia. Isointense signal also found in T2WI in remission cases. The difference of T1 value in lumber, CNR in lumber/subcutaneous fat and femur/subcutaneous fat, B% in blood and marrow were significant (Plt;0.05) among groups of diagnosis and control, diagnosis and remission; but they weren?t significant (pgt;0.05) between groups of control and remission