Turk J Med Sci. 2019 Apr 18;49(2):644-652. doi: 10.3906/sag-1812-125.
BACKGROUND/AIM: The main purpose of our study was to determine the efficacy of chemical shift imaging (CSI) for differentiating diffuse red bone marrow reconversion (RBMR) and hematological malignancies. We also aimed to calculate the cut-off value for these entities with similar imaging features in routine magnetic resonance (MR) sequences.
A total of 54 patients were included: 17 patients (31.4%) with hematological malignancies (group 1), 16 patients (29.6%) with RBMR (group 2), and 21 patients (38.0%) with no clinical and hematological malignancies (control group). Patients with no pathological data or completed two-year follow-up and children were excluded from the study. An experienced radiologist on MRI evaluated the images blindly for final diagnosis. Pathologic results were determined as gold standard. Regions of interests (ROI) were placed on the vertebrae in CSI and signal intensity ratios (SIR) were calculated. The cut-off value was calculated using receiver operating characteristic (ROC) analysis.
SIR values were 0.97 ± 0.16, 0.69 ± 0.31 and 0.28 ± 0.35 (P < 0.001) for GI, G2, and G3, respectively. The cut-off value was 0.82 (P < 0.001). The sensitivity rate was 83.3% (AUC: 58%–96%), specificity was 87% (AUC: 58–98).
CSI may be a valuable diagnostic tool for differentiating diffuse RBMR and hematological malignancies.
背景/目的：本研究的主要目的是确定化学位移成像（CSI）在区分弥漫性红骨髓重建（RBMR）和血液系统恶性肿瘤方面的功效。我们还旨在计算具有相似成像特征的这些实体在常规磁共振（MR）序列中的截断值。
共纳入 54 例患者：17 例（31.4%）血液系统恶性肿瘤患者（第 1 组），16 例（29.6%）RBMR 患者（第 2 组）和 21 例（38.0%）无临床和血液系统恶性肿瘤患者（对照组）。排除无病理数据或完成两年随访的患者和儿童。一名有经验的 MRI 放射科医生对图像进行盲法评估，以做出最终诊断。病理结果为金标准。在 CSI 上对椎体进行感兴趣区域（ROI）放置，并计算信号强度比（SIR）。使用受试者工作特征（ROC）分析计算截断值。
SIR 值分别为 GI、G2 和 G3 的 0.97 ± 0.16、0.69 ± 0.31 和 0.28 ± 0.35（P < 0.001）。截断值为 0.82（P < 0.001）。灵敏度率为 83.3%（AUC：58%-96%），特异性为 87%（AUC：58%-98%）。
CSI 可能是区分弥漫性 RBMR 和血液系统恶性肿瘤的有价值的诊断工具。
