Whole-body bone marrow DWI correlates with age, anemia, and hematopoietic activity
Whole-body bone marrow DWI correlates with age, anemia, and hematopoietic activity
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DOI：
10.1016/j.ejrad.2019.07.022
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发表时间：
2019-09-01
影响因子：
3.3
通讯作者：
Okazawa, Hidehiko
中科院分区：
文献类型：
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作者：
Tsujikawa, Tetsuya;Oikawa, Hiroshi;Okazawa, Hidehiko
目的：从人体测量、全血计数(CBC)和C反应蛋白(CRP)中确定骨髓DWI信号的预测因素，并评估其与患者脂肪含量的关系。方法：这项回顾性研究得到机构审查委员会的批准。共有113名肿瘤患者接受了全身PET/MRI检查。测量腰椎(L3-5)和双侧髂骨的表观扩散系数(ADC)和质子密度脂肪分数(PDFF)，并取平均值。由于呼吸运动，肋骨根据DWI的3点视觉评分进行评估，b=800(1：不可见，2：部分可见，3：完全可见)。检查ADC/视觉评分与人体测量学、血细胞计数、C反应蛋白和PDFF的关系。结果：多元回归分析发现年龄是腰椎ADC的最强预测因素(标准化系数β=0.45)，其次是红细胞分布宽度(RDW)(β=-0.24)，年龄是髂骨ADC的最强预测因素(β=0.43)，其次是血红蛋白(β=0.22)。RDW对肋骨视觉评分的预测作用最强(β=0.47)，年龄次之(β=-0.39)。L3-5和髂骨的ADC值与PDFF呈显著正相关。结论：年龄、贫血(低Hb)和造血活动增强(高RDW)是预测ADC和DWI上红骨髓可见度的主要因素。中年女性的脂肪抑制方法和骨髓生理可能影响了ADC值和PDF值之间的测量相关性，这与以前的研究不一致。
Purpose: To identify the predictors of bone-marrow DWI signals from anthropometric, complete blood count (CBC), and C-reactive protein (CRP), and to evaluate the association with fat-content in patients.Method: This retrospective study was approved by the institutional review board. A total of 113 consecutive tumor patients underwent whole-body PET/MRI. Apparent diffusion coefficient (ADC) and proton density fat fraction (PDFF) were measured and averaged in lumbar vertebrae (L3-5) and bilateral ilia. Due to respiratory motion, ribs were evaluated by 3-point visual scoring on DWI with b = 800 (1: invisible, 2: partially visible, 3: fully visible). The relationships between ADC/visual scores and anthropometric, CBC, CRP, and PDFF were examined. In females, the age-dependency was evaluated.Results: Multi-regression analyses identified age as the strongest predictor of lumbar ADC (standardized coefficient beta = 0.45), followed by red cell distribution width (RDW) (beta = - 0.24), while age was the strongest predictor of iliac ADC (beta = 0.43), followed by hemoglobin (Hb) (beta = 0.22). RDW was the strongest predictor (beta = 0.47) for rib visual score and age was the second (beta = -0.39). ADC showed significant positive correlations with PDFF at L3-5 and ilium. Lumbar ADC showed a decreasing trend during middle age in females.Conclusions: Age, anemia (lower Hb), and increased hematopoietic activity (higher RDW) are the predominant predictors of ADC and the visibility of red marrow on DWI. Fat-suppression methods and bone-marrow physiology in middle-aged females may have affected the measured correlations between ADC and PDFF inconsistent with previous studies.