Evidence for clonal disease by magnetic resonance imaging in patients with hypoplastic marrow disorders.
Evidence for clonal disease by magnetic resonance imaging in patients with hypoplastic marrow disorders.
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DOI：
10.1182/blood.v78.11.2872.2872
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发表时间：
1991-12
期刊：
影响因子：
20.3
通讯作者：
William G. Negendank;D. Weissman;TM Bey;M. D. Planque;C. Karanes;Smith;V. Ratanatharathorn;Carter R. Bishop;Ayad Al-Katib;L. Sensenbrenner
中科院分区：
文献类型：
--
作者：
William G. Negendank;D. Weissman;TM Bey;M. D. Planque;C. Karanes;Smith;V. Ratanatharathorn;Carter R. Bishop;Ayad Al-Katib;L. Sensenbrenner
一些患有再生障碍性骨髓疾病（包括再生障碍性贫血（AA））的患者有克隆演变为骨髓增生异常综合征（MDS）和白血病的风险。对24例骨髓发育不良的患者进行了脊柱、骨盆和股骨骨髓的磁共振成像（MRI）检查。在12例患者（3 AA，9 MDS）的MRI是兼容的临床和活检诊断，并在这些疾病的骨髓模式的频谱定义。在8例骨髓活检和临床诊断为AA的患者中，MRI显示了意外的不均匀或弥漫性细胞模式。同时或随后的骨髓或细胞遗传学研究导致这些患者中的7例诊断为发育不良型MDS。在4例淋巴瘤骨髓移植后长期发育不良的患者中，在系列MRI研究中出现了叠加在脂肪背景上的斑点图案。1例发展为AML，2例发生巨幼细胞灶，1例在19个月时仍发育不全。本研究表明，MRI能够发现AA患者的早期克隆性疾病，并可以区分AA和增生不良的MDS。
Some patients with hypoplastic marrow disorders, including aplastic anemia (AA), are at risk for clonal evolution to myelodysplastic syndromes (MDS) and leukemia. Magnetic resonance imaging (MRI) of marrow of the spine, pelvis, and femurs was performed in 24 patients with hypoplastic marrow disorders. In 12 patients (three AA, nine MDS) MRI was compatible with the clinical and biopsy diagnoses and served to define the spectrum of marrow patterns in these disorders. In eight patients with hypocellular marrow biopsies and a clinical diagnosis of AA, MRI showed an unexpected inhomogeneous or diffuse cellular pattern. Concurrent or subsequent marrow or cytogenetic studies have led to diagnoses of hypoplastic MDS in seven of these patients. In four patients with prolonged hypoplasia after bone marrow transplantation for lymphoma, a speckled pattern superimposed on a fatty background appeared in serial MRI studies. One case evolved to AML, two developed megaloblastic foci, and one remains hypoplastic at 19 months. This study suggests that MRI is able to detect early clonal disease in patients with AA, and can distinguish AA from hypoplastic MDS.