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目的探讨慢性粒细胞白血病(chronicmyeloid leukemia,CML)骨髓磁共振成像(MRI)表现及临床价值。方法收集成人CML50例,其中初诊慢性期患者16例,治疗后病情稳定于慢性期者18例,病情发展到加速期者7例,发生急性变者9例。所有患者均行骨盆及股骨中上段MRI检查。结果初诊慢性期及进展到加速和急变期的患者SE序列T1WI表现为髂骨及股骨骨髓弥漫性低信号或仅有在股骨头、大转子处残留斑片状高信号。治疗后维持在慢性期的患者SE序列T1WI表现为髂骨弥漫性低信号为主,夹杂点片状高信号,股骨主要表现为高低混杂信号。初诊慢性期组与治疗后组、治疗后组与加速急变组MRI表现差异有统计学意义(P<0.01);初诊慢性期组与加速急变期组差异无统计学意义(P>0.05)。结论CML患者骨髓MRI能反映其病程演变,与临床特点结合,有助于CML的诊断分期,对监测病情发展、提示加速和急变有重要价值。
Objective To investigate the clinical manifestations and clinical value of bone marrow magnetic resonance imaging (MRI) of chronic myeloid leukemia (CML). Methods Fifty patients with adult CML were collected, including 16 newly diagnosed chronic patients, 18 patients with chronic stable disease after treatment, 7 patients with accelerated progression and 9 acute exacerbations. All patients underwent pelvic and femur MRI examination. Results In the newly diagnosed patients with chronic phase and advanced to accelerated phase, the SE sequence T1WI showed diffuse low signal in the ilium and femur and bone marrow or only the high patchy signal in the femoral head and the greater trochanter. T1WI of SE sequence in patients with chronic phase maintained after treatment was characterized by diffuse low signal of iliac crest, flaky high signal of inclusion point and high and low mixed signal of femur. There were significant differences in the MRI findings between the newly diagnosed group and the post-treatment group, the post-treatment group and the accelerated group (P <0.01). There was no significant difference between the newly diagnosed group and the accelerated group (P> 0.05). Conclusion The bone marrow MRI of CML patients can reflect the course of its disease. Combining with the clinical features, it is helpful to diagnose the stage of CML and has important value in monitoring the progression of the disease, suggesting the acceleration and rapid change.