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目的分析多发性骨髓瘤骨盆磁共振(MR)表观弥散系数(ADC)值与骨髓瘤细胞百分比的相关性,探讨ADC值对多发性骨髓瘤化疗效果的评价价值。方法采用1.5T MR扫描仪对14例多发性骨髓瘤(MM)患者在化疗前后进行骨盆MR常规扫描和DWI(b=800)成像,选定病灶为感兴趣区,并测量其ADC800值,同时应用骨髓穿刺涂片检测相应感兴趣区的瘤细胞百分比,进行相关性分析。结果 14例患者化疗前后共28次骨髓穿刺点骨髓瘤细胞百分比与相应感兴趣区的ADC800值呈正相关(r=0.962,P=0.000<0.001)。14例患者化疗后9例完全缓解,5例部分缓解,骨髓ADC800值治疗前为(7.6±2.3)×10-4mm2/s,治疗后为(4.2±1.5)×10-4mm2/s,差异具有统计学意义(P<0.001)。结论骨盆MR表观弥散系数(ADC)值与骨髓瘤细胞百分比成正相关,ADC800可作为多发性骨髓瘤疗效的无创性评价指标。
Objective To analyze the correlation between the apparent diffusion coefficient (ADC) of pelvic MR and the percentage of myeloma cells in multiple myeloma and to evaluate the value of ADC in the evaluation of chemotherapy efficacy in multiple myeloma. Methods 14 cases of multiple myeloma (MM) were scanned by conventional MRI and DWI (b = 800) before and after chemotherapy with a 1.5T MR scanner. The selected lesion was selected as the region of interest and ADC800 value was measured. At the same time, The percentage of tumor cells in the corresponding region of interest was detected by using the bone marrow aspirate smear, and the correlation analysis was carried out. Results The percentage of myeloma cells in 28 patients with bone marrow puncture was positively correlated with ADC800 in the corresponding region of interest (r = 0.962, P = 0.000 <0.001). Among the 14 patients, 9 were completely relieved after chemotherapy and 5 were partly relieved. The bone marrow ADC800 before treatment was (7.6 ± 2.3) × 10-4mm2 / s and after treatment was (4.2 ± 1.5) × 10-4mm2 / s, the difference was Statistical significance (P <0.001). Conclusions Apparent diffusion coefficient (ADC) value of pelvis is positively correlated with the percentage of myeloma cells. ADC800 can be used as a noninvasive evaluation index for the efficacy of multiple myeloma.