Roca Espiau Mercedes
Centro de Diagnóstico por Imagen, Zaragoza, Spain.
Med Clin (Barc). 2011 Sep;137 Suppl 1:23-31. doi: 10.1016/S0025-7753(11)70013-6.
The exposition aims, is to review the pathophysiological mechanisms of bone marrow involvement and the patterns of marrow infiltration by Gaucher cells. We have reviewed the different methods of assessment of bone marrow infiltration and its temporal development. Qualitative methods include simple radiography, magnetic resonance imaging (MRI), computed tomography (CT) and radioisotope. The simple radiography is the basic element, but its sensitivity is limited and only allows for assessing changes and trabecular bone remodeling MRI allows us to appreciate the bone marrow infiltration, detection of complications and response to therapy. Radioisotopes can contribute to the differential diagnosis of osteomyelitis and bone crises. Among the quantitative methods are the QCSI (quantitative chemical shift imaging) and the dual-energy X-ray absorptiometry (DEXA), as well as new quantitative techniques of CT, MRI and ultrasound densitometry. The QCSI performed an assessment of fat content of bone marrow in the spine. DEXA quantifies bone density by measuring the attenuation coefficient. The semiquantitative methods have various "scores" to establish criteria for generalized bone disease endpoints of disease progression and response to therapy.
本次论述旨在回顾骨髓受累的病理生理机制以及戈谢细胞的骨髓浸润模式。我们回顾了评估骨髓浸润及其时间发展的不同方法。定性方法包括简单放射照相、磁共振成像（MRI）、计算机断层扫描（CT）和放射性同位素。简单放射照相是基本手段，但其敏感性有限，仅能评估变化和小梁骨重塑。MRI使我们能够了解骨髓浸润情况、检测并发症以及评估治疗反应。放射性同位素有助于骨髓炎和骨危象的鉴别诊断。定量方法包括定量化学位移成像（QCSI）和双能X线吸收法（DEXA），以及CT、MRI和超声骨密度测定的新定量技术。QCSI用于评估脊柱骨髓的脂肪含量。DEXA通过测量衰减系数来量化骨密度。半定量方法有各种“评分”，以建立全身性骨病疾病进展终点和治疗反应的标准。
