Nishii Tatsuya, Kono Atsushi K, Akasaka Yoshinobu, Mori Takeshi, Hayakawa Akira, Iijima Kazumoto, Sugimura Kazuro
Department of Radiology, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Hyogo, Japan,
Jpn J Radiol. 2015 Mar;33(3):146-52. doi: 10.1007/s11604-015-0394-5. Epub 2015 Feb 5.
An MRI-based pre-test to determine the probability of pediatric leukemia prior to bone marrow aspiration would be useful to prevent unnecessary exposure to this invasive test. We aimed to evaluate the clivus-to-pons signal intensity ratio (CPR) and visual scoring (VS) on T1-weighted images (T1WI) and diffusion-weighted images (DWI) to distinguish pediatric leukemia patients from normal controls.
We retrospectively reviewed 1.5-T brain MR images of 13 consecutive leukemia patients (3 girls, 10 boys; mean age, 8.23 years; range, 1-17 years) and 40 age- and gender-matched normal controls. We evaluated differences between leukemia patients and normal controls using Wilcoxon rank-sum and Mann-Whitney U tests with respect to the following parameters: (1) CPR on T1WI (CPRT1WI); (2) CPR on DWI (CPRDWI); (3) VS on T1WI (VST1WI); and (4) VS on DWI (VSDWI).
The CPRT1WI values for leukemia patients and normal controls were 0.77 ± 0.12 and 1.39 ± 0.47, respectively (P < 0.001). The corresponding CPRDWI values were 1.03 ± 0.38 and 0.50 ± 0.17, respectively (P < 0.001). VST1WI and VSDWI were significantly different between the groups (P < 0.001 for both).
MRI-based quantitative and qualitative analyses of clival bone marrow on T1WI and DWI can distinguish pediatric leukemia patients from normal subjects.
在进行骨髓穿刺前,基于磁共振成像(MRI)的预测试以确定小儿白血病的概率,对于防止不必要地接受这种侵入性检查将是有用的。我们旨在评估在T1加权图像(T1WI)和扩散加权图像(DWI)上的斜坡至脑桥信号强度比(CPR)和视觉评分(VS),以区分小儿白血病患者与正常对照。
我们回顾性分析了13例连续白血病患者(3例女孩,10例男孩;平均年龄8.23岁;范围1 - 17岁)和40例年龄及性别匹配的正常对照的1.5T脑部MR图像。我们使用Wilcoxon秩和检验和Mann - Whitney U检验评估白血病患者与正常对照在以下参数方面的差异:(1)T1WI上的CPR(CPRT1WI);(2)DWI上的CPR(CPRDWI);(3)T1WI上的VS(VST1WI);以及(4)DWI上的VS(VSDWI)。
白血病患者和正常对照的CPRT1WI值分别为0.77±0.12和1.39±0.47(P < 0.001)。相应的CPRDWI值分别为1.03±0.38和0.50±0.17(P < 0.001)。两组之间的VST1WI和VSDWI有显著差异(两者P均< 0.001)。
基于MRI对斜坡骨髓在T1WI和DWI上进行的定量和定性分析能够区分小儿白血病患者与正常受试者。