急性髓细胞白血病全身骨髓浸润MRI与血清VEGF表达的相关性研究-影像医学与核医学专业论文.docx

山两医科人学硕I：学位论文急性髓细胞白血病全身骨髓浸润MRI 山两医科人学硕I：学位论文 急性髓细胞白血病全身骨髓浸润MRI 与血清VEGF表达的相关性研究 中文摘要 目的： 采用快速自旋回波(FSE)T1WI观察急性髓细胞白血病(AML)骨髓MRI 表现，与血清血管内皮生长因子(VEGF)含量对照研究。 方法： 24例确诊初发AML患者，分六个部位完成全身骨髓MRI检查，包括头、 颈椎、胸椎、胸骨；腰椎、骶椎；双侧肱骨、胫骨、股骨，根据骨髓浸润的程度、 范围分级。同时测定AML患者外周血VEGF含量。 结果：24例AML患者脊柱、骨盆、颅骨、胸骨骨髓广泛浸润；双侧肱骨、股骨、 胫骨不同程度骨髓浸润。肱骨、股骨浸润范围大的患者出现双侧胫骨浸润。按照 胫骨浸润的程度，将AML患者MRI骨髓浸润范围分为3级：I级、胫骨未见浸润 病灶；II级、胫骨骨髓浸润，范围不超过胫骨全长1／2，HI级、胫骨骨髓浸润， 范围超过胫骨全长1／2。24例患者全身骨髓浸润范围分级，其中I级14例，Ⅱ 级6例，Ⅲ级4例。AML患者外周血VEGF含量，其范围在3．13-49．48之间，累 计logit回归分析显示AML骨髓浸润的程度分级与血清VEGF含量的相关性具有 统计学意义，尸值为0．016。 结论：全身MRI检查能全面显示AML骨髓浸润的范围及严重程度，与血清学VEGF 含量正相关。全身骨髓MRI有望能为AML预后评价、抗肿瘤血管治疗提供更多临 床信息。 关键词； 全身；磁共振成像；骨髓；急性髓细胞白血病；VEGF ll The The correlation Whole—body MRI of bone marrow with Vascular endothelial growth factor in patients with acute myeloid leukemia Abstract Objective：To assess the whole—body fast spin echo Tl weight imaging(FSE TlWD magnetic resonance imaging(MRI)for detecting bone marrow in patients with acute myeloid leukemia(AML)and tO correlate the results with vascular endothelial growth factor(、慢GF)plasma levels． Methods：Twenty—four patients with AML(mean age=47 years．age range：8—72 years)were assessed for infiltrated bone marrow with whole．body MRI and measurement of VEGF levels by enzyme linked immunosorbent assay(ELISA)Six parts in each patient were assessed with FSE Tl M during MRI．Whole—body MRl were compared with VEGF levels． Results：MR imaging showed that bone marrow in all patients were infiltrated by leukemia cells，but the scope of infiltration were different among patients．MR imaging of femoral marrow were classified into three patterns according to size of infiltrated marrow in tibia．The VEGF plasma levels were from3．13 to 49．48．The correlation MRI degrees with VEGF plasma levels were significant difference (P--0．016)． Conclusion：Whole—body MRI is a reliable method for manifesting bone marrow in patients with AML．The degrees of infiltrated bone marrow were correlated with VEGF plasma levels． Key Words：whole body，mag