全身MRI中用于多发性骨髓瘤的表观扩散系数（ADC）测量：三种b值与两种b值扩散加权成像（DWI）的比较

ADC measurement in whole-body MRI for multiple myeloma: a three b-values vs. two b-values DWI comparison.

作者信息

Zerunian Marta, Masci Benedetta, Pugliese Dominga, Nardacci Stefano, Polici Michela, Pucciarelli Francesco, De Santis Domenico, Caruso Damiano, La Verde Giacinto, Laghi Andrea

机构信息

Radiology Unit-Department of Surgical-Medical Sciences and Translational Medicine, Sapienza University of Rome-Sant'Andrea University Hospital, Via Di Grottarossa, 1035-1039, 00189, Rome, Italy.

Department of Medical and Surgical Sciences and Translational Medicine, Faculty of Medicine and Psychology, PhD School in Translational Medicine and Oncology, Sapienza University of Rome, Rome, Italy.

出版信息

Radiol Med. 2025 Jun 3. doi: 10.1007/s11547-025-02026-7.

DOI:10.1007/s11547-025-02026-7

PMID:40459647

Abstract

PURPOSE

To compare apparent diffusion coefficient (ADC) values in whole-body MRI (WB-MRI) reconstructed from diffusion-weighted imaging (DWI) with three b-values (50-500-1000 s/mm) compared with two b-values (50-1000 s/mm).

MATERIALS AND METHODS

Patients with multiple myeloma who underwent 1.5 T WB-MRI were retrospectively included. Exclusion criteria were severe motion artifacts. Examinations included axial DWI with three b-values (50-500-1000 s/mm); ADC maps were reconstructed with both three values of b(ADC3b) and two values of b(ADC2b) excluding b500 s/mm. According to MY-RADS guideline, bone lesion with ADC values 700-1400 µm/sec was considered malignant and regions of interests (ROIs) were placed in bone lesions and healthy bone marrow. Both malignant lesions and healthy bone ADC3b were compared with ADC2b, considering as significant p < 0.05. In case of discordant ROIs on the two ADC maps for malignity/benignity, expert radiologists examined all the WB-MRI sequences to assign a malignant/benign qualitative assessment.

RESULTS

Fifty-five patients (25 females, 29-83 yo) were retrospectively included; 305 bone lesions and 303 healthy bone segments were assessed. Objective analysis showed different ADC values between bone lesions' in ADC3b and ADC2b (965.3 ± 216.7 µm/sec vs 937.2 ± 218.8 µm/sec, p < 0.0001) and in healthy bone marrow ROIs (588 ± 271.7 vs 573.1 ± 573.1 ± 271.2, p < 0.0001). Despite significant differences, almost all the analyzed ROIs lay in the same range of ADC for bone lesions. 10/305 bone lesions fell into the range of malignity for ADC3b while showing lower values < 700 µm/sec for ADC2b (ADC3b 715.82 ± 190.9 µm/sec vs. ADC2b 687.72 ± 185.2 µm/sec); focal bone lesion with discordant values was then confirmed as lesions, in accordance with ADC3b, by a panel of experts that blind-reviewed the whole sequences of the examinations.

CONCLUSION

ADC2b is comparable with ADC3b except for borderline values (650-750 µm/sec).

摘要

目的

比较通过扩散加权成像（DWI）重建的全身MRI（WB-MRI）中，采用三个b值（50 - 500 - 1000 s/mm²）与两个b值（50 - 1000 s/mm²）时的表观扩散系数（ADC）值。

材料与方法

回顾性纳入接受1.5T WB-MRI检查的多发性骨髓瘤患者。排除标准为严重运动伪影。检查包括采用三个b值（50 - 500 - 1000 s/mm²）的轴向DWI；分别使用三个b值（ADC3b）和两个b值（排除b500 s/mm²，即ADC2b）重建ADC图。根据MY-RADS指南，ADC值为700 - 1400 µm²/sec的骨病变被视为恶性，在骨病变和健康骨髓中放置感兴趣区（ROI）。将恶性病变和健康骨的ADC3b与ADC2b进行比较，p < 0.05被视为有显著差异。如果两个ADC图上的ROI在恶性/良性判断上不一致，由专家放射科医生检查所有WB-MRI序列以进行恶性/良性定性评估。

结果

回顾性纳入55例患者（25名女性，29 - 83岁）；评估了305个骨病变和303个健康骨段。客观分析显示，骨病变在ADC3b和ADC2b中的ADC值不同（965.3 ± 216.7 µm²/sec vs 937.2 ± 218.8 µm²/sec，p < 0.0001），健康骨髓ROI中的ADC值也不同（588 ± 271.7 vs 573.1 ± 271.2，p < 0.0001）。尽管存在显著差异，但几乎所有分析的ROI在骨病变的ADC范围内处于相同区间。305个骨病变中有10个在ADC3b中处于恶性范围，而在ADC2b中显示较低值< 700 µm²/sec（ADC3b 715.82 ± 190.9 µm²/sec vs. ADC2b 687.72 ± 185.2 µm²/sec）；一组专家对检查的整个序列进行盲法复查，随后将具有不一致值的局灶性骨病变按照ADC3b确认为病变。