Bone marrow microcirculation analysis in multiple myeloma by contrast-enhanced dynamic magnetic resonance imaging
Bone marrow microcirculation analysis in multiple myeloma by contrast-enhanced dynamic magnetic resonance imaging
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DOI：
10.1002/ijc.1421
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发表时间：
2001-09-15
影响因子：
6.4
通讯作者：
Goldschmidt, H
中科院分区：
文献类型：
--
作者：
Moehler, TM;Hawighorst, H;Goldschmidt, H
我们研究的目的是通过对比增强动态磁共振成像 (dMRI) 来研究定量微循环参数振幅 A（假设血管内容量）和交换率常数 k(21)（假设血管通透性）作为多发性骨髓瘤 (MM) 血管生成的标志物。因此，使用 dMRI 方案以及泵控制钆-DTPA 推注输注对 16 名正常对照和 41 名活动性 MM 患者的腰椎和髂后上脊柱进行了评估。根据二室模型计算药代动力学参数、振幅A和交换速率常数k(21)。颜色编码的参数图像是根据药代动力学数据分析生成的，并叠加到传统的 MR 图像上。与对照组相比，MM 患者的振幅 A 和 k(21) 参数显着增加（p = 0.001；中位 A(ctr)，0.2 [范围，0.09-0.4]；中位 A(MM)，0.93 [范围，0.2-2.2]；中位 k(21ctr)，0.09 min(-1) [范围，0.03-0.9]；中位k(21MM), 4.58（范围，0.22-23.8]）。在 MM 患者组中，发现颜色编码参数图像的模式为“弥散”（n = 13，31%）或“局灶”（n = 28，69%）类型的微循环分布，比较药代动力学图的“局灶”与“弥散”模式的患者的振幅 A。 “局灶”组中振幅 A 值显着增加，可根据严重溶骨性骨受累对患者进行分类（p = 0.023），振幅 A 的最佳截止值为 0.7。我们的数据表明，dMRI 是一种用于检测和监测 MM 骨病变的新型成像技术，它为 MM 的血管生成提供了独立证据。 2001 威利利斯公司
The aim of our study was to investigate the quantitative microcirculation parameters amplitude A (hypothetical intravascular volume) and exchange rate constant k(21) (hypothetical vascular permeability) by contrast-enhanced dynamic magnetic resonance imaging (dMRI) as markers of angiogenesis in multiple myeloma (MM). Therefore lumbar spine and spina iliaca superior posterior of 16 normal controls and 41 patients with active MM were assessed using a dMRI protocol with a pump controlled bolus infusion of Gadolinium-DTPA. Pharmacokinetic parameters, amplitude A and exchange rate constant k(21) were calculated according to a 2-compartment model. Color-coded parameter images were generated from pharmacokinetic data analysis and superimposed onto the conventional MR images. Amplitude A and k(21) parameters were significantly increased in patients with MM compared with controls (p = 0.001; median A(ctr), 0.2 [range, 0.09-0.4]; median A(MM),0.93 [range, 0.2-2.2]; median k(21ctr), 0.09 min(-1) [range, 0.03-0.9]; median k(21MM), 4.58 (range, 0.22-23.8]). Within the group of MM patients the pattern of color-coded parameter images were found to be either of "diffuse" (n = 13, 31%) or "focal" (n = 28, 69%) type of distribution of microcirculation. Comparison of amplitude A in patients with "focal" vs. "diffuse" pattern of the pharmacokinetic maps revealed a significant increase in the median of amplitude A in the "focal" group. Amplitude A values allowed a classification of patients according to severe osteolytic bone involvement (p = 0.023) with the best cutoff value of 0.7 for amplitude A. Downmodulation of amplitude A was observed in a MM patient treated with standard VAD chemotherapy. Our data demonstrate that dMRI is a novel imaging technique for the detection and monitoring of MM bone lesions. It provides independent evidence for angiogenesis in MM. (C) 2001 Wiley-Liss, Inc.