第3代双源双能CT虚拟去钙骨髓成像在多发性骨髓瘤弥漫浸润性病变评价中的应用

发布时间：2018-04-25 04:38

本文选题：多发性骨髓瘤 + 弥漫浸润性病变　；参考：《中国医学科学院学报》2017年01期

【摘要】：目的探讨第3代双源双能CT(DSDECT)虚拟去钙(VNCa)骨髓成像在多发性骨髓瘤(MM)弥漫浸润性病变评价中的应用价值。方法以2015年12月至2016年6月在北京协和医院就诊的31例浆细胞病患者为研究对象,行全身第3代DSDECT和全身MRI检查。在VNCa及常规CT图像测定椎体CT值,评价椎体VNCa CT值与MRI信号强度相关性。以MRI为参考标准,评价VNCa对MM弥漫浸润病变的诊断力。结果 MM弥漫浸润椎体组(n=62)VNCa的平均CT值为(-13.27±18.96)HU,明显高于非弥漫浸润椎体组(n=117)的(-63.31±26.75)HU,(Z=-9.731,P=0.000)。椎体VNCa CT值与T1 WI序列椎体和无退变椎间盘信号强度比值呈显著负相关(rs=-0.592,P=0.000)。VNCa诊断MM弥漫浸润病变的受试者工作曲线下面积为0.943;VNCa CT值-37 HU时的敏感性为90.32%,特异性为87.18%。结论第3代DSDECT VNCa骨髓成像具有诊断MM弥漫浸润病变的能力。
[Abstract]:Objective to evaluate the value of the third generation dual energy CTD DSDECT virtual decalcification (VN Ca) bone marrow imaging in the evaluation of diffuse infiltrative lesions of multiple myeloma (MM). Methods from December 2015 to June 2016, 31 patients with plasmacytosis were examined by DSDECT and MRI. The CT value of vertebral body was measured by VNCa and conventional CT images, and the correlation between VNCa CT value and MRI signal intensity was evaluated. Using MRI as the reference standard, the diagnostic power of VNCa for diffuse infiltrative lesions of MM was evaluated. Results the average CT value of VNCa in the diffuse infiltrating vertebral body group was -13.27 卤18.96 Hu, which was significantly higher than that in the non-diffuse infiltrating vertebral body group (-63.31 卤26.75). There was a significant negative correlation between CT value of vertebral body and signal intensity ratio of vertebral body and nondegenerative intervertebral disc on T 1WI sequence. The sensitivity was 90.32 and the specificity was 87.18 when the area under the operating curve was 0.943 and the area under the operating curve was -37 Hu. Conclusion the third generation DSDECT VNCa bone marrow imaging has the ability to diagnose diffuse infiltrative lesions of MM.
【作者单位】：中国医学科学院北京协和医学院北京协和医院放射科;中日友好医院放射科;中国医学科学院北京协和医学院北京协和医院血液科;
【基金】：国家临床重点专科建设项目(2014) 卫生公益性行业科研专项项目(201402019)~~
【分类号】：R733.3;R730.44

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