Wang Qin, Sun Zhaoyong, Li Shuo, Zhang Haibo, Li Jian, Zhang L U, Xue Huadan, Jin Zhengyu
Department of Radiology,PUMC Hospital,CAMS and PUMC,Beijing 100730,China.
Department of Radiology,China-Japan Friendship Hospital,Beijing 100029,China.
Zhongguo Yi Xue Ke Xue Yuan Xue Bao. 2017 Feb 20;39(1):114-119. doi: 10.3881/j.issn.1000-503X.2017.01.019.
Objective To evaluate the value of bone marrow imaging by third-generation dual-source dual-energy CT(DSDECT) using virtual noncalcium(VNCa) technique for the assessment of diffuse infiltrative lesions of multiple myeloma(MM). Methods From December 2015 to June 2016,31 patients with plasma disorders at our center were prospectively recruited and received whole-body imaging with third-generation DSDECT and MRI. CT numbers of vertebrae were measured on VNCa images as well as regular CT images. Correlation between VNCa CT numbers and MRI signal intensities of the vertebrae was evaluated. The diagnostic ability of VNCa for MM infiltrative lesions was assessed by ROC analysis,using MRI as the reference standard. Results The mean VNCa CT numbers of vertebrae with MM diffuse infiltration (n=62) were (-13.27±18.96)HU,which were significantly higher than those of non-infiltrated vertebrae[(-63.31±26.75)HU,(n=117)] (Z=-9.731,P=0.000). VNCa CT numbers of vertebrae were negatively correlated with T1WI signal intensity normalized by non-degenerative vertebral discs (r=-0.592,P=0.000). ROC analysis showed the area under the curve of VNCa for the diagnosis of infiltrative lesions was 0.943. With the cut-off value of-37 HU,the sensitivity and specificity of VNCa were 90.32% and 87.18%,respectively. Conclusion Bone marrow imaging by third-generation DSDECT using VNCa technique is a valuable tool for assessing diffuse infiltrative lesions of MM.
目的 评估采用虚拟去钙（VNCa）技术的第三代双源双能量CT（DSDECT）骨髓成像在评估多发性骨髓瘤（MM）弥漫性浸润性病变中的价值。方法 2015年12月至2016年6月，前瞻性招募了本中心31例血浆疾病患者，对其进行第三代DSDECT和MRI全身成像。在VNCa图像以及常规CT图像上测量椎体的CT值。评估VNCa CT值与椎体MRI信号强度之间的相关性。以MRI作为参考标准，通过ROC分析评估VNCa对MM浸润性病变的诊断能力。结果 MM弥漫性浸润椎体（n = 62）的平均VNCa CT值为（-13.27±18.96）HU，显著高于未浸润椎体[（-63.31±26.75）HU，（n = 117）]（Z = -9.731，P = 0.000）。椎体的VNCa CT值与经非退变椎间盘标准化的T1WI信号强度呈负相关（r = -0.592，P = 0.000）。ROC分析显示，VNCa诊断浸润性病变的曲线下面积为0.943。以-37 HU为截断值，VNCa的敏感性和特异性分别为90.32%和87.18%。结论 采用VNCa技术的第三代DSDECT骨髓成像对于评估MM弥漫性浸润性病变是一种有价值的工具。
