Dynamic Contrast Enhanced Magnetic Resonance Imaging of Diffuse Spinal Bone Marrow Infiltration in Patients with Hematological Malignancies.
10.3348/kjr.2010.11.2.187
- Author:
Yunfei ZHA
1
;
Maojin LI
;
Jianyong YANG
Author Information
1. Department of Radiology, Renmin Hospital of Wuhan University, Wuhan, China. zhayunfei@hotmail.com
- Publication Type:Original Article ; Evaluation Studies
- Keywords:
Bone marrow;
Hematologic neoplasms;
Magnetic resonance (MR);
Dynamic contrast enhancement
- MeSH:
Adolescent;
Adult;
Aged;
Bone Marrow Neoplasms/pathology;
Child;
Contrast Media/*diagnostic use;
Female;
Gadolinium DTPA/diagnostic use;
Hematologic Neoplasms/*pathology;
Humans;
Image Enhancement/methods;
Leukemia/*pathology;
Lymphoproliferative Disorders/*pathology;
Magnetic Resonance Imaging/*methods;
Male;
Middle Aged;
Observer Variation;
Prospective Studies;
Spinal Neoplasms/*pathology;
Young Adult
- From:Korean Journal of Radiology
2010;11(2):187-194
- CountryRepublic of Korea
- Language:English
-
Abstract:
OBJECTIVE: To investigate the significance of the dynamic contrast enhanced magnetic resonance imaging (DCE-MRI) parameters of diffuse spinal bone marrow infiltration in patients with hematological malignancies. MATERIALS AND METHODS: Dynamic gadolinium-enhanced MR imaging of the lumbar spine was performed in 26 patients with histologically proven diffuse bone marrow infiltration, including multiple myeloma (n = 6), acute lymphoblastic leukemia (n = 6), acute myeloid leukemia (n = 5), chronic myeloid leukemia (n = 7), and non-Hodgkin lymphoma (n = 2). Twenty subjects whose spinal MRI was normal, made up the control group. Peak enhancement percentage (Emax), enhancement slope (ES), and time to peak (TTP) were determined from a time-intensity curve (TIC) of lumbar vertebral bone marrow. A comparison between baseline and follow-up MR images and its histological correlation were evaluated in 10 patients. The infiltration grade of hematopoietic marrow with plasma cells was evaluated by a histological assessment of bone marrow. RESULTS: Differences in Emax, ES, and TTP values between the control group and the patients with diffuse bone marrow infiltration were significant (t = -11.51, -9.81 and 3.91, respectively, p < 0.01). Emax, ES, and TTP values were significantly different between bone marrow infiltration groups Grade 1 and Grade 2 (Z = -2.72, -2.24 and -2.89 respectively, p < 0.05). Emax, ES and TTP values were not significantly different between bone marrow infiltration groups Grade 2 and Grade 3 (Z = -1.57, -1.82 and -1.58 respectively, p > 0.05). A positive correlation was found between Emax, ES values and the histological grade of bone marrow infiltration (r = 0.86 and 0.84 respectively, p < 0.01). A negative correlation was found between the TTP values and bone marrow infiltration histological grade (r = -0.54, p < 0.01). A decrease in the Emax and ES values was observed with increased TTP values after treatment in all of the 10 patients who responded to treatment (t = -7.92, -4.55, and 5.12, respectively, p < 0.01). CONCLUSION: DCE-MRI of spine can be a useful tool in detecting diffuse marrow infiltration of hematological malignancies, while its parameters including Emax, ES, and TTP can reflect the malignancies' histological grade.
