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用于评估多发性骨髓瘤的新型全身连续床动协议与标准全身 MR 协议的比较。

Comparison of a new whole-body continuous-table-movement protocol versus a standard whole-body MR protocol for the assessment of multiple myeloma.

机构信息

Department of Clinical Radiology, University Hospital Munich-Grosshadern Campus, Marchioninistr. 15, 81377, Munich, Germany.

出版信息

Eur Radiol. 2010 Dec;20(12):2907-16. doi: 10.1007/s00330-010-1865-9. Epub 2010 Jun 24.

Abstract

OBJECTIVES

To evaluate a whole body (WB) continuous-table-movement (CTM) MR protocol for the assessment of multiple myeloma (MM) in comparison to a step-by-step WB protocol.

METHODS

Eighteen patients with MM were examined at 1.5T using a WB CTM protocol (axial T2-w fs BLADE, T1-w GRE sequence) and a step-by-step WB protocol including coronal/sagittal T1-w SE and STIR sequences as reference. Protocol time was assessed. Image quality, artefacts, liver/spleen assessability, and the ability to depict bone marrow lesions less than or greater than 1 cm as well as diffuse infiltration and soft tissue lesions were rated. Potential changes in the Durie and Salmon Plus stage and the detectability of complications were assessed.

RESULTS

Mean protocol time was 6:38 min (CTM) compared to 24:32 min (standard). Image quality was comparable. Artefacts were more prominent using the CTM protocol (P = 0.0039). Organ assessability was better using the CTM protocol (P < 0.001). Depiction of bone marrow and soft tissue lesions was identical without a staging shift. Vertebral fractures were not detected using the CTM protocol.

CONCLUSIONS

The new protocol allows a higher patient throughput and facilitates the depiction of extramedullary lesions. However, as long as vertebral fractures are not detectable, the protocol cannot be safely used for clinical routine without the acquisition of an additional sagittal sequence.

摘要

目的

评估全身(WB)连续运动(CTM)MR 方案在评估多发性骨髓瘤(MM)方面与逐步 WB 方案的比较。

方法

18 例 MM 患者在 1.5T 上使用 WB CTM 方案(轴位 T2-w fs BLADE、T1-w GRE 序列)和逐步 WB 方案(包括冠状/矢状 T1-w SE 和 STIR 序列)进行检查作为参考。评估方案时间。评价图像质量、伪影、肝/脾可评估性,以及描绘小于或大于 1cm 的骨髓病变以及弥漫性浸润和软组织病变的能力。评估潜在的 Durie 和 Salmon Plus 分期变化以及并发症的检测能力。

结果

平均方案时间为 6:38 分钟(CTM)与 24:32 分钟(标准)。图像质量相当。使用 CTM 方案时,伪影更明显(P=0.0039)。使用 CTM 方案时,器官可评估性更好(P<0.001)。骨髓和软组织病变的描述相同,分期无变化。使用 CTM 方案无法检测到椎体骨折。

结论

新方案允许更高的患者吞吐量,并有利于描绘髓外病变。然而,只要无法检测到椎体骨折,在不采集额外的矢状序列的情况下,该方案就不能安全地用于临床常规。

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