MRI、CT及X线在诊断多发性骨髓瘤中的应用比较
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摘要
目的 MRI、CT及X线在诊断多发性骨髓瘤(MM)中的应用比较。方法选择2017年1月到2018年1月到医院就诊MM患者80例,所有患者均进行MRI、CT、X线检查。统计MRI、CT、X线三种检查方式的影像特征,统计MRI、CT、X线三种检查方式诊断效能,及对不同部位骨损害病灶检出率。结果 X线检查中80例患者病变类型最多为骨质破坏型,占比80%;CT检查中80例患者病变类型最多为骨质破坏型,占比87.50%;MRI检查中80例患者病变类型最多为局灶型,占比52.50%;MRI诊断准确率、灵敏度均高于CT、X线,差异有统计学意义(P<0.05);MRI、CT、X线三种检查方法特异度差异无统计学意义(P>0.05);MRI检查在颅骨病灶检出率高于CT及X线,差异有统计学意义(P<0.05);MRI、CT、X线三种检查方式在病灶位于脊椎、盆骨、肋骨及四肢处检出率差异无统计学意义(P>0.05)。结论 MRI对MM诊断准确率、灵敏度均高于CT、X线,并在颅骨处病灶检查更有优势。
Objective To compare the MRI, CT and X-ray in the diagnosis of multiple myeloma(MM). Methods A total of 80 cases of MM who were admitted to the hospital from January 2017 to January 2018 were selected and given MRI, CT, and X-ray examinations. The imaging features and the diagnostic efficacy of MRI, CT and X-ray were analyzed. The detection rates of bone lesions in different sites were recorded by MRI, CT and X-ray. Results Among 80 patients, the most common type of lesion is bone destruction in X-ray, accounting for 80%. In CT examination, the most common lesion was bone destruction, accounting for 87.50%. In MRI, the most common lesion type was multifocal type, accounting for 52.50%. The accuracy and sensitivity of MRI diagnosis were higher than those of CT and X-ray(P<0.05). There was no statistical significance in the specificity of MRI, CT and X-ray(P>0.05). The detection rate of skull lesions by MRI was higher than that by CT and X-ray(P<0.05). There was no significant difference in the detection rates of lesions in spine, pelvis, ribs and extremities by MRI, CT and X-ray(P>0.05). Conclusion The accuracy and sensitivity of MRI for MM diagnosis are higher than those of CT and X-ray, and MRI is more advantageous in the examination of lesions in skull.
Objective To compare the MRI, CT and X-ray in the diagnosis of multiple myeloma(MM). Methods A total of 80 cases of MM who were admitted to the hospital from January 2017 to January 2018 were selected and given MRI, CT, and X-ray examinations. The imaging features and the diagnostic efficacy of MRI, CT and X-ray were analyzed. The detection rates of bone lesions in different sites were recorded by MRI, CT and X-ray. Results Among 80 patients, the most common type of lesion is bone destruction in X-ray, accounting for 80%. In CT examination, the most common lesion was bone destruction, accounting for 87.50%. In MRI, the most common lesion type was multifocal type, accounting for 52.50%. The accuracy and sensitivity of MRI diagnosis were higher than those of CT and X-ray(P<0.05). There was no statistical significance in the specificity of MRI, CT and X-ray(P>0.05). The detection rate of skull lesions by MRI was higher than that by CT and X-ray(P<0.05). There was no significant difference in the detection rates of lesions in spine, pelvis, ribs and extremities by MRI, CT and X-ray(P>0.05). Conclusion The accuracy and sensitivity of MRI for MM diagnosis are higher than those of CT and X-ray, and MRI is more advantageous in the examination of lesions in skull.
引文
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[10]陈益飞,陆益龙.57例多发性骨髓瘤患者生存及预后因素分析[J].中国实验血液学杂志,2017,25(5):1436-1443.
[11]范荣,牛金亮.多发性骨髓瘤影像学研究进展[J].中国医学影像技术,2018,34(5):787-790.
[12]唐文娇,笪熠,林强,等.胸部CT在多发性骨髓瘤骨病变及临床预后评价中的价值[J].中华内科杂志,2015,54(8):711-715.
[13]翁艺菲,戚荣丰,卢光明.多发性骨髓瘤伴蝶鞍斜坡区浆细胞瘤CT及MRI表现(附3例报告及文献复习[J].中国临床医学影像杂志,2016,27(8):580-583.
[14]胡青竹,田颖,王根杰,等.X线和MRI在多发性骨髓瘤诊断中的应用价值及影像表现分析[J].中国CT和MRI杂志,2018,16(1):141-143.
[15]刘杰.多发性骨髓瘤的X线、CT、MRI和18F-FDGPET/CT诊断价值[J].中国CT和MRI杂志,2017,15(3):132-133,140.
[2]李翰卿,翟勇平.流式细胞术检测多发性骨髓瘤免疫表型和残留病灶的研究进展[J].中国实验血液学杂志,2015,23(1):241-245.
[3]丁飞,朱平,伍学强.多发性骨髓瘤发病的分子机理和恶性克隆演化[J].中国实验血液学杂志,2015,23(5):1513-1516.
[4]庄韵,沈群.多发性骨髓瘤维持治疗的最新进展[J].中国实验血液学杂志,2015,23(1):250-254.
[5]路瑾.立足中国实际的骨髓瘤诊治-《中国多发性骨髓瘤诊治指南(第四版)》解读[J].中国实用内科杂志,2016,36(05):376-378.
[6]Rajkumar S V.Updated Diagnostic Criteria and Staging System for Multiple Myeloma[J].American Society of Clinical Oncology educational book/ASCO.American Society of Clinical Oncology,Meeting,2016,35:e418.
[7]刘萌萌,许洪志,冯秀梅,等.多发性骨髓瘤肾损害危险因素及其可逆性预测指标的临床相关研究[J].中国实验血液学杂志,2015,23(3):722-727.
[8]Song I,Kim J,Choi Y,et al.Diagnostic and Prognostic Implications of Spine Magnetic Resonance Imaging at Diagnosis in Patients with Multiple Myeloma[J].Cancer Research&Treatment,2015,47(3):465-472.
[9]褚彬,陆敏秋,吴梦青,等.多发性骨髓瘤骨病临床特点及监测骨代谢标志物的临床意义[J].中华医学杂志,2016,96(18):1424-1429.
[10]陈益飞,陆益龙.57例多发性骨髓瘤患者生存及预后因素分析[J].中国实验血液学杂志,2017,25(5):1436-1443.
[11]范荣,牛金亮.多发性骨髓瘤影像学研究进展[J].中国医学影像技术,2018,34(5):787-790.
[12]唐文娇,笪熠,林强,等.胸部CT在多发性骨髓瘤骨病变及临床预后评价中的价值[J].中华内科杂志,2015,54(8):711-715.
[13]翁艺菲,戚荣丰,卢光明.多发性骨髓瘤伴蝶鞍斜坡区浆细胞瘤CT及MRI表现(附3例报告及文献复习[J].中国临床医学影像杂志,2016,27(8):580-583.
[14]胡青竹,田颖,王根杰,等.X线和MRI在多发性骨髓瘤诊断中的应用价值及影像表现分析[J].中国CT和MRI杂志,2018,16(1):141-143.
[15]刘杰.多发性骨髓瘤的X线、CT、MRI和18F-FDGPET/CT诊断价值[J].中国CT和MRI杂志,2017,15(3):132-133,140.