论文部分内容阅读
目的采用全身MRI技术观察急性髓细胞白血病(AML)骨髓MRI表现,与血清血管内皮生长因子(VEGF)含量对照研究,分析其临床意义。资料与方法24例确诊初发AML患者,分6次完成全身骨髓MRI检查,包括头颅、脊柱、胸骨、骨盆、双侧肱骨、股骨、胫骨。同时测定AML患者外周血VEGF含量。结果24例AML患者颅骨、脊柱、骨盆、胸骨骨髓广泛浸润;双侧肱骨、股骨、胫骨不同程度骨髓浸润。肱骨、股骨浸润范围大的患者出现双侧胫骨浸润。按照胫骨浸润的程度,将AML患者MRI骨髓浸润范围分为3级:Ⅰ级,胫骨未见浸润病灶;Ⅱ级,胫骨骨髓浸润,范围不超过胫骨全长1/2;Ⅲ级,胫骨骨髓浸润,范围超过胫骨全长1/2。24例中Ⅰ级14例,Ⅱ级6例,Ⅲ级4例。AML患者外周血VEGF含量,其范围在3.13～49.48之间,累计logit回归分析显示AML骨髓浸润的程度分级与血清VEGF含量的相关性具有统计学意义,P值为0.016。结论全身MRI检查能全面显示AML骨髓浸润的范围及严重程度,与血清学VEGF含量呈正相关。全身骨髓MRI有望能为AML预后评价、抗肿瘤血管治疗提供更多临床信息。
Objective To observe the clinical manifestations of bone marrow MRI in acute myeloid leukemia (AML) by using whole-body MRI and to compare with the serum vascular endothelial growth factor (VEGF) content and to analyze its clinical significance. Materials and Methods 24 cases of newly diagnosed AML patients were diagnosed with whole body bone marrow MRI in 6 times, including head, spine, sternum, pelvis, bilateral humerus, femur and tibia. Simultaneous determination of VEGF in peripheral blood of AML patients. Results A total of 24 cases of AML patients had extensive infiltration of the skull, spine, pelvis and sternum. The bilateral humerus, femur and tibia were infiltrated with bone marrow. Humerus, femoral infiltration in patients with a wide range of bilateral tibial infiltration. According to the degree of tibial infiltration, the range of MRI bone marrow infiltration of AML patients was divided into three grades: grade Ⅰ, no infiltrative lesions of tibia; Grade Ⅱ, infiltration of tibia bone marrow, the range does not exceed the total length of tibia 1/2; Ⅲ, tibial bone marrow infiltration , Which exceeded the total length of the tibia in 1 / 2.24 cases of grade Ⅰ in 14 cases, Ⅱ grade in 6 cases, Ⅲ grade in 4 cases. AML patients with peripheral blood VEGF levels, ranging from 3.13 to 49.48 between the cumulative logit regression analysis showed that the degree of bone marrow infiltration of AML and serum VEGF levels were statistically significant (P = 0.016). Conclusion The whole body MRI can fully display the extent and severity of bone marrow infiltration in AML, which is positively correlated with the serum VEGF. Whole-body bone marrow MRI is expected to provide more clinical information for the evaluation of AML prognosis and anti-tumor vascular therapy.