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目的探讨磁共振表观弥散系数(apparent diffusion coefficient,ADC)值对多发性骨髓瘤患者化疗效果的无创性评价价值。方法收集2012年1月—2014年3月确诊的多发性骨髓瘤共21例,共计35例次,采用1.5T高场磁共振扫描仪对35例次多发性骨髓瘤患者进行多次骨盆磁共振多参数成像,测定ADC值,同时应用骨髓穿刺涂片评估相应穿刺点瘤细胞百分比,计量资料采用t检验,对ADC值与瘤细胞百分比进行Spearman相关性分析,P<0.05为差异有统计学意义。结果21例患者35次骨髓穿刺后骨髓涂片骨髓瘤细胞百分比与相应穿刺点的ADC值呈正相关,差异有统计学意义(r=0.989,P<0.05)。患者化疗后骨髓瘤细胞比例不同程度下降,骨髓ADC值亦有下降,治疗前为(7.6±2.3)×10-4mm2/s,治疗后为(4.2±1.5)×10-4mm2/s,对比差异有统计学意义(P<0.05)。结论骨盆磁共振ADC值与相应穿刺点的骨髓瘤细胞百分比成正相关,骨盆磁共振ADC值有助于无创性评价多发性骨髓瘤的化疗效果。
Objective To investigate the value of noninvasive evaluation of the apparent diffusion coefficient (ADC) of MR imaging in patients with multiple myeloma. Methods Twenty-one patients with multiple myeloma diagnosed from January 2012 to March 2014 were collected for a total of 35 cases. Multiple magnetic resonance imaging (MRI) was performed in 35 patients with multiple myeloma using a 1.5T high-field magnetic resonance scanner Multi-parameter imaging, determination of ADC value, while the application of bone marrow biopsy smear assessment of the corresponding percentage of puncturing tumor cells, measurement data using t test, the ADC value and the percentage of tumor cells Spearman correlation analysis, P <0.05 was considered statistically significant . Results The percentage of bone marrow smear myeloma cells in 35 cases after bone marrow aspiration was positively correlated with the ADC value at the corresponding puncture point in 21 patients (r = 0.989, P <0.05). The proportion of myeloma cells decreased to varying degrees in patients with chemotherapy, bone marrow ADC values also decreased, before treatment was (7.6 ± 2.3) × 10-4mm2 / s, after treatment was (4.2 ± 1.5) × 10-4mm2 / s, the difference was significant There was statistical significance (P <0.05). Conclusion The ADC value of pelvic MRI is positively correlated with the percentage of myeloma cells at the corresponding puncture point. The ADC value of pelvic MRI is helpful to evaluate the non-invasive evaluation of the chemotherapy effect of multiple myeloma.