Sun Mengtian, Cheng Jingliang, Ren Cuiping, Zhang Yong, Li Yinhua, Wang Linlin, Liu Yu
Department of Magnetic Resonance, The First Affiliated Hospital of Zhengzhou University, 1st, Jianshe Dong Road, Zhengzhou, Henan Province, 450052, China.
Department of Hematology, The First Affiliated Hospital of Zhengzhou University, 1st, Jianshe Dong Road, Zhengzhou, Henan Province, 450052, China.
J Magn Reson Imaging. 2022 Apr;55(4):1213-1225. doi: 10.1002/jmri.27934. Epub 2021 Sep 24.
The visual assessment used for diffuse infiltration of multiple myeloma (MM) is inadequate. It can be difficult to differentiate MM from hyperplastic hematopoietic bone marrow (HHBM) because the MRI signal characteristics overlap.
To analyze the bone marrow diffuse signal changes on whole-body MRI caused by MM and HHBM.
Retrospective.
Thirty Four patients with MM (21 men and 13 women), 22 patients with HHBM (9 men and 13 women), and 15 healthy controls (9 men and 6 women).
FIELD STRENGTH/SEQUENCE: A 3.0 T MRI; diffusion-weighted whole-body imaging with background body signal suppression (DWIBS), modified Dixon T1 fast field echo, and T2 STIR.
Three radiologists analyzed the whole-body MRI alone and in combination with apparent diffusion coefficient (ADC) and fat fraction (FF) with qualitative and quantitative analysis. Normalized T1 and T2 signal intensities (nT1 and nT2) and signal-to-noise ratio (SNR) were obtained.
Kruskal-Wallis and chi-square tests.
The MM group had significantly higher ADC and significantly lower FF than HHBM and control groups. There was no significant difference in nT1, nT2 or SNR between MM and HHBM (P = 0.932, P = 0.097, and P = 0.110, respectively). Receiver operating characteristic (ROC) analysis using ADC and FF cut-off values of 0.47 × 10 mm /sec and 20.63%, respectively. The AUC was 0.866 for ADC and 0.886 for FF. The quantitative analysis yielded better specificity (observer 1: 81.8% vs. 27.3%; observer 2: 68.2% vs. 22.7%; and observer 3: 72.7% vs. 18.2%) and a higher diagnostic accuracy (observer 1: 82.1% vs. 51.8%; observer 2: 80.4% vs. 50.0%; observer 3: 76.8% vs. 44.6%) than the qualitative analysis.
Whole-body MRI combined with DWIBS and mDIXON could be used to differentiate between MM and HHBM. Combining the quantitative ADC and FF with the whole-body MRI improved the specificity and accuracy in differentiating these conditions.
3 TECHNICAL EFFICACY: Stage 2.
用于评估多发性骨髓瘤（MM）弥漫性浸润的视觉评估方法并不充分。由于MRI信号特征存在重叠，因此很难将MM与增生性造血骨髓（HHBM）区分开来。
分析MM和HHBM导致的全身MRI骨髓弥漫性信号变化。
回顾性研究。
34例MM患者（21例男性，13例女性），22例HHBM患者（9例男性，13例女性），以及15名健康对照者（9例男性，6例女性）。
场强/序列：3.0 T MRI；背景体部信号抑制扩散加权全身成像（DWIBS）、改良Dixon T1快速场回波成像和T2脂肪抑制反转恢复序列。
三名放射科医生单独分析全身MRI，并结合表观扩散系数（ADC）和脂肪分数（FF）进行定性和定量分析。获得标准化T1和T2信号强度（nT1和nT2）以及信噪比（SNR）。
Kruskal-Wallis检验和卡方检验。
MM组的ADC显著高于HHBM组和对照组，FF显著低于HHBM组和对照组。MM组和HHBM组之间的nT1、nT2或SNR无显著差异（P分别为0.932、0.097和0.110）。采用ADC和FF临界值分别为0.47×10⁻³ mm²/sec和20.63%进行受试者操作特征（ROC）分析。ADC的曲线下面积（AUC）为0.866，FF的AUC为0.886。与定性分析相比，定量分析具有更高的特异性（观察者1：81.8%对27.3%；观察者2：68.2%对22.7%；观察者3：72.7%对18.2%）和更高的诊断准确性（观察者1：82.1%对51.8%；观察者2：80.4%对50.0%；观察者3：76.8%对44.6%）。
全身MRI联合DWIBS和mDIXON可用于区分MM和HHBM。将定量ADC和FF与全身MRI相结合可提高区分这些情况的特异性和准确性。
3级 技术效能：2级
