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成人急性白血病初诊骨髓MRI表面及临床应用.pdf 38页
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山西医科大学
硕士学位论文
成人急性白血病初诊骨髓MRI表面及临床应用研究
姓名：牛金亮
申请学位级别：硕士
专业：影像医学
指导教师：韩郁英;王峻
成人急性白血病初诊髑l髓涨l表现
及瞒床超用研究
蓦瓣：磷疑黢天AL辫蠹耪敬诊麟霹爨然筑爨捩撩节餐鬣熬
MRI表蜣，擒忝麓人鼹嚣疆浸澜黪特鬣救壤德，搽讨脊髓拣娥餐
凌蛙渗舔、袋耩译嵇、渗疗效聚蘸测审豹裕徕癍臻价傻。留攘54
键确诊戏大熊惹者(AML28铆，ALL26例)行骨盆及驳骨巾上莰
督麓凇成像，采稽s毽序弼及STIR膳虢桶制弹剿澈状使拓拣，煎
期搜蒙荫髓象及船常规检豢络聚。选取ls菠零悫愿髯对照。壤纂
艇霄患溪鹣肖不同骥度姻没滤爨炊，将黄髓URI袭凝按澄滤蕊毽
投严重糕壤分冀玉缎，AML毖蠹23(82％)爨翳l一瓣缓，5(|随)
镪壤Ⅳ级，髭V缀爨键；矗魄惑卷12(《蠛)铡藏群缀，l《(§瞄)
钢瓣V羰，滗l一礞级薅铡，涎鍪意袁瓣{分缎惑俸瓣势带蓑辩
嚣藩<辩0。009)。赣窳獒辩魄较溪爽，弼蘩恚赣雾端、8淞、P彗t
之耀盼嫠器有统诗掌意义，P缓稳小于O．05，MRl分疑为辩缴的
AML怒者，缓鞯率较I一撒缀嚣低。麓羚肖最蓑穗(黔心。043)，
姗分缎为V缓酶艋L患者岛Ⅳ缓黪卷缓謦察鳃嫠搏蠢最萋黢
(P蝴．052)0皱谂：嫩露髓戏像撬驻暴地蹙麓瓣全载，艇静髓没
濑是一个遴续的发嫒越道稷，娥予级蚤髓，焚黉髓受繁较魏，商
糍鬟之转。挺R帮艇蠛缘窍秘予全蕊浮貉爨考势麓德，耱凳筑意誊
确诊据供影像学依摇。裙诊AML誊者骨髓躲I袭现对病情的评倍、
缓解的预测有重要的临床应用价值。
Bone marrow MR imaging of adult acute leukemic
patients with untreated and the value
of clinical application
objectlve To observe bone marrow MR imaging of adult acute
leukemic patients in first diagnosis．To reveal the rule of bone
iTlalTOW infiltration and the role of MRI in diagnosis and predicting
prognosis ofadult acute leukemia with untreated．Methods 54 adun
acute leukemic patients received MPd after diagnosis reling 013 FAB
subtype including 28 cases with AML and 26 cases with A11．MR
Imagings were obtained by the short time inversion recovery and T1-
weighted spin echo technique of pelvis and femur at one time。The
examining results of morphologicand and blood routine were collected
at the same time．15 age-matched volunteers WCre selected as controls．
Results MRI showed that bone man'ow ofall patients were infiltrated
by leukemic cells．The MRI appearance was classified into five patterns
basing on scope of focus。MRI patters from grade lto grade 3 were
observed in most of patients with AMLand in none with
ALL,however,all patients晰也ALL distributed in grade 4幻grade
5。The distributing ofpatterns have significant difference between AML
and ALL(P知。009)。There were significant difference in the eotmts of
PBl’ andBMTas well aS WBC betw∞珏 AML and
Au，(p=0．050，旷0．009，p=0．022 respectiv
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