关键词：骨髓移植； 磁共振成像；白血病
【摘要】 目的 研究MRI对白血病骨髓移植(BMT)患者骨髓变化的评估作用和价值。方法 共20例白血病BMT患者，分别在BMT前后行SE序列T1 WI和脂肪抑制成像；并测量腰椎骨髓T1 弛豫时间。结果 17例BMT后骨髓在T1 WI上信号强度升高，复发率5.88%；3例信号无变化者，复发率66.70%；两组间复发率差异具有显著性意义(P<0.05)。BMT后腰椎骨髓T1 值低于正常值(P<0.05)；与BMT前相比，有下降趋势，但差异无统计学意义。研究结果不支持腰椎“带状”表现是BMT后早期特征性表现。结论 MRI是监测白血病BMT后骨髓再生造血和预示复发的有效影像学检查手段。
MR imaging of leukemicpatients after bone marrow transplantation
HE Juan, LIAN Zongcheng, HANMingzhe,et al.
Department of Radiology, the Second Hospital, Tianjin Medical University, Tianjin 300211
【 Abstract 】 Objective To assess the role of magnetic resonance imaging(MRI) ofbone marrow in leukemic patients after bone marrow transplantation(BMT). Methods 20 leukemic patients received thefirst MRI before pretransplant regimen and second MRI was performed in a median of 52 daysafter transplantation with fat-suppressed and/or T1 -weighted images of lumbar,pelvis and femur respectively. 14 age-matched volunteers were selected as controls. Results In 3 chronic myelogenousleukemia, the MRI of the pretransplant marrow pattern was mainly cellularmarrow(hypointensities on T1 -weighted images) in three examined sites. In 17acute leukemia, the lumbar and pelvis marrow pattern did not demonstrate significantdiscrepancies compared with the normal, but patchy foci of cellular marrow were detectedin the femoral shaft which was easier to be detected on fat-suppressed images than T1 WI.After BMT, 17 cases showed relatively increased signal intensity compared with thepretransplant on T1 -weighted images, clinically with a lower rate of recurrence(5.88%). The other 3 cases with a higher rate of recurrence(66.70%) did not demonstrateany changes. The difference of the two groups was statistically significant(P<0.05).The “band pattern” , which was a peripheral zone ofintermediate signal intensity surrounding a central zone of bright signal intensity, wasdemonstrated in 5 posttransplant patients and 9 pretransplant patients, and was alsoobserved in the normal. So our results did not support the point of view that the “band pattern”was an early characteristic change after BMT. Conclusions MRI is an important noninvasivetool for investigating large regions of marrow in the monitoring of those patients withleukemia undergoing BMT and has a potential to predict recurrence. The combination of T1 -weightedand fat-suppressed images is an effective imaging method, and the combination of femur andeither lumbar or pelvis is an optimal site for imaging.
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