全身磁共振成像在多发性骨髓瘤诊断与治疗效果评价中的价值

摘要

目的 评价全身MRI在多发性骨髓瘤(multiple myeloma,MM)诊断与治疗效果评价中的应用价值.方法 采用Siemens 3.0T 磁共振对47例经病理证实的MM患者进行化疗前全身MRI,并分别于标准方案化疗3月后及6月后复查.对每一位患者全身MRI发现的病灶进行计数统计,采用多因素方差分析比较化疗前、化疗后3月、化疗后6月全身MRI病灶数有无统计学差异.结果 47例MM中,正常型5例,弥漫型7例,局灶型25例,混合型3例,椒盐型7例.对可视病灶的治疗后随访中(正常型除外,共42例),化疗前全身MRI病灶平均数为(113.90±45.71)个,化疗3月后病灶数平均为(28.00±22.49)个,化疗6月后病灶数平均为(10.04±9.02)个.化疗前与化疗后3个月MRI病灶数有显著性差异(P<0.05),化疗后3个月与6个月之间MRI病灶数有显著性差异(P<0.05).结论 全身MRI对MM具有较好的诊断价值;对评价MM标准化疗方案后的治疗效果有良好的临床应用价值.%Objective To investigate the value of whole-body magnetic resonance imaging (WB-MRI) for diagnosis and treatment efficacy evaluation of multiple myeloma (MM). Methods Forty-seven patients with MM verified by histology were recruited. All the patients underwent WB-MRI before chemotherapy and were followed up at 3 and 6 months after standard chemotherapy regimen treatment. The lesions found on WB-MRI of each patient were counted on different time point respectively. The numbers of the lesions found on different time point were compared using multi-way ANOVA statistic analysis. Results Five imaging patterns were identified on WB-MRI, which were smoldering type (5 patients) , diffuse type (7 patients) , focal type (25 patients) , mixed type (3 patients), and salt and pepper type (7 patients). There were 42 patients with visible lesions followed up by WB-MRI after chemotherapy. The mean number of lesions was 113. 90 ± 45. 71 on WB-MRI before chemotherapy and decreased to 28. 00 ± 22. 49 and 10.04 ± 9.02 at the third and sixth month on follow-up WB-MRI. Significant differences were confirmed between cither two of the three groups (P<0. 05). Conclusion WB-MRI is a valuable tool for MM diagnosis and has an important clinical value for evaluating the treatment efficacy after chemotherapy.