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MRI在恶性血液病骨浸润中的应用价值 被引量:2

Applicability of MRI in diagnosis of bone infiltration of leukemia
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摘要 目的探讨恶性血液病骨浸润的MRI表现及临床相关特征。方法采用回顾性分析,对2016年1月—2019年12月航天中心医院血液科住院的24例血液病伴骨浸润患者的相关资料进行分析。结果白血病骨浸润患者中包括急性白血病17例(71%),其中急性淋巴细胞白血病3例,急性髓系白血病M 2型7例,M5型5例,M 6型2例;慢性白血病2例(8%),包括慢性淋巴细胞白血病及慢性髓系白血病分别有1例;淋巴瘤3例(13%),包括T淋巴母细胞淋巴瘤2例,B淋巴母细胞淋巴瘤1例;另外粒细胞肉瘤2例(8%)。所有患者均出现骨浸润局部阳性体征。骨浸润部位最多出现在骨盆诸骨,其次为四肢关节,以及脊柱椎体。影像学表现为T1WI低信号,T2WI呈高信号,增强后明显强化,边界尚清。基因检测M LL/A F阳性2例,A M L1-ETO阳性2例,WT1阳性4例,BCR-ABL阳性1例。血生化检查显示乳酸脱氢酶(lactate dehydrogenase,LDH)、碱性磷酸酶(alkaline phosphatase,ALP)多明显升高。结论MRI扫描对诊断恶性血液病骨浸润定性诊断特异性较高,且定位诊断准确,为确诊骨浸润提供影像学依据,有助于临床病情评估和疗效评价。 Objective To investigate the MRI findings and clinical characteristics of bone infiltration in hematological malignancies.Methods Retrospective analysis was performed of the clinical data on twenty-four cases of leukemia with bone infiltration hospitalized in our hospital between January 2016 and December 2019.Results Among these patients,there were seventeen cases(71%)of acute leukemia,including three cases of acute lymphoblastic leukemia,seven cases of acute myeloid leukemia type M2,five cases of M5,and two cases of M6.There were two cases of chronic leukemia(8%),including one case of chronic lymphocytic leukemia and one case of chronic myeloid leukemia.There were three cases of lymphoma(13%),including two cases of T lymphoblastic lymphoma and one case of B lymphoblastic lymphoma.The other two cases(8%)were granulocytic sarcomas.All patients showed positive signs of local bone infiltration.The most common sites of bone infiltration were pelvic bones,followed by the joints of limbs and the vertebral body of the spine.The imaging findings showed low signals of T1WI,high signals of T2WI,obvious enhancement after enhancement,and clear boundaries.There were two cases of positive MLL/AF,two cases of positive AML1-ETO,four cases of positive WT1 and one case of positive BCR-ABL.Biochemical examination of blood showed that lactate dehydrogenase(LDH)and alkaline phosphatase(ALP)increased more significantly.Conclusion MRI scan has a high specificity in the qualitative diagnosis of bone infiltration in malignant hematologic diseases and is capable of accurate localization,which provides imaging data for the diagnosis of bone infiltration and contributes to assessment of clinical conditions a nd efficacy evaluation.
作者 柏冬 许亚茹 BAI Dong;XU Yaru(Department of Radiology,Aerospace Central Hospital,Beijing 100049,China;不详)
出处 《空军医学杂志》 2021年第4期317-319,349,共4页 Medical Journal of Air Force
关键词 白血病 骨浸润 MRI leukemia bone invasion magnetic resonance imaging
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