Detection of malignant bone marrow involvement with dynamic contrast-enhanced magnetic resonance imaging
Detection of malignant bone marrow involvement with dynamic contrast-enhanced magnetic resonance imaging
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DOI：
10.1093/annonc/mdg007
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发表时间：
2003-01-01
影响因子：
50.5
通讯作者：
Dimopoulos, MA
中科院分区：
文献类型：
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作者：
Moulopoulos, LA;Maris, TG;Dimopoulos, MA
背景：本研究的目的是评估动态对比增强磁共振成像 (dMRI) 在检测癌症患者骨髓受累方面的作用。患者和方法：我们使用腰骶椎 dMRI 连续研究了 50 名经组织学证实恶性扩散至骨髓的患者。时间信号强度曲线是从明显骨髓疾病区域（B 组）获得的感兴趣区域（ROI）生成的。在来自 B 组的 16 名患有病灶的患者中，ROI 也被放置在静态磁共振图像上骨髓明显正常的区域（C 组）。将22例无恶性肿瘤病史的患者作为对照组（A组）。计算每位患者的洗入 (WIN) 和洗出 (WOUT) 率、达到峰值的时间 (TTPK)、达到最大斜率的时间 (TMSP) 值以及 WIN/TMSP 比率。对三组的平均值进行统计比较。 B 组中的 6 名患者在化疗后进行了随访 dMRI：4 名患者实现了临床部分缓解，2 名患者出现耐药性疾病。 结果：A 组和 B 组的所有值均存在显着差异。 A 组和 C 组之间，尽管静态 MRI 外观相似，但所有值均显着不同。 B 组和 C 组之间，WIN、WOUT 率和 WIN/TMSP 比率存在显着差异。后续dMRI数据分析与临床分期相关性良好。结论：dMRI可以区分正常和恶性骨髓。它可以识别静态 MRI 阴性患者的恶性骨髓浸润，并可作为骨髓恶性肿瘤患者的诊断和预后工具。
Background: The purpose of this study was to evaluate the role of dynamic contrast-enhanced magnetic resonance imaging (dMRI) in detecting bone marrow involvement in cancer patients.Patients and methods: We studied 50 consecutive patients with histologically confirmed malignant dissemination to the bone marrow, using dMRI of the lumbosacral spine. Time-signal intensity curves were generated from regions of interest (ROIs) obtained from areas of obvious bone marrow disease (group B). In 16 patients from group B with focal disease, ROIs were also placed on areas with apparently normal bone marrow on static magnetic resonance images (group C). Twenty-two patients with no history of malignancy were used as a control group (group A). Wash-in (WIN) and wash-out (WOUT) rates, time to peak (TTPK), time to maximum slope (TMSP) values and WIN/TMSP ratios were calculated for each patient. Mean values for the three groups were compared statistically. Six patients from group B had follow-up dMRI after chemotherapy: four patients achieved a clinical partial response and two had resistant disease.Results: A significant difference was found between groups A and B for all values. Between groups A and C, in spite of the similar static MRI appearance, all values were significantly different. Between groups B and C, a significant difference was found for WIN, WOUT rates and WIN/TMSP ratio. Follow-up dMRI data analysis correlated well with clinical staging.Conclusions: dMRI can distinguish normal from malignant bone marrow. It may identify malignant bone marrow infiltration in patients with negative static MRI and serve as both a diagnostic and prognostic tool for patients with bone marrow malignancies.