Diagnostic value of whole body magnetic resonance diffusion weighted imaging combined with multi-slice spiral CT in multiple myeloma
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摘要:
目的 探究全身磁共振弥散加权成像(WB-DWI)联合多层螺旋CT对多发性骨髓瘤的诊断价值。 方法 选取2019年6月~2023年1月于我院收治的80例多发性骨髓瘤患者为研究对象, 并按照检测方式将其分为WB-DWI组(n=25)、多层螺旋CT组(n=25)、联合组(n=30)。分析WB-DWI、多层螺旋CT单一及联合对患者累及部位的检出率, 分析两种检查方式单一及联合对多发性骨髓瘤的检出情况, 通过ROC曲线分析WB-DWI、多层螺旋CT联合诊断多发性骨髓瘤的临床价值。 结果 检测结果主要与Durie-Salmon分期、国际骨髓瘤分期相关(P < 0.05)。与WB-DWI、多层螺旋CT单一检测对比, 联合检测患者累及部位的检出率较高(P < 0.05)。在多发性骨髓瘤诊断中WB-DWI、多层螺旋CT联合检测高于单一检测(P < 0.05)。与WB-DWI、多层螺旋CT单项诊断对比, 两项联合诊断多发性骨髓瘤的敏感度、特异性、准确性均较高(P < 0.05)。 结论 相较于WB-DWI、多层螺旋CT单项检测, 联合检测可有效提升患者病理检出情况, 提高对多发性骨髓瘤的诊断价值。 -
关键词:
- 多发性骨髓瘤 /
- 全身磁共振弥散加权成像 /
- 多层螺旋CT /
- 国际肿瘤分期
Abstract:Objective To explore the diagnostic value of whole body magnetic resonance diffusion weighted imaging (WB-DWI) combined with multi-slice spiral CT in multiple myeloma. Methods A total of 80 patients with multiple myeloma admitted to our hospital from June 2019 to January 2023 were selected as study subjects and divided into WB-DWI group (n=25), multi-slice spiral CT group (n=25) and combined group (n=30). The detection rates of WB-DWI and multi-slice spiral CT alone and combined in the involved sites of patients were analyzed, and the detection of multiple myeloma by the two methods alone and combined was analyzed. The clinical value of WB-DWI and multi-slice spiral CT combined in the diagnosis of multiple myeloma was analyzed by ROC curve. Results The results were mainly correlated with Durie-Salmon stage and international myeloma stage (P < 0.05). Compared with the single detection of WB-DWI and multi-slice spiral CT, the detection rate of the involved sites in the combined detection was higher (P < 0.05). The combined detection of WB-DWI and multi-slice spiral CT was higher than that of single detection in the diagnosis of multiple myeloma (P < 0.05). Compared with the single diagnosis of WB-DWI and multi-slice spiral CT, the sensitivity, specificity and accuracy of the combined diagnosis of multiple myeloma were higher (P < 0.05). Conclusion Compared with WB-DWI and multi-slice spiral CT single tests, the combined test can effectively improve the pathological detection of patients and improve the diagnostic value of multiple myeloma. -
图 1 患者WB-DWI(A)及CT(B)图像
Figure 1. WB-DWI (A) and CT (B) image of patient. A: Multiple spotted high-signal foci in the collarbones, scapula, ribs, thoracic vertebra, pelvis and bilateral femur; B: Multiple patchy low-density bone destruction of bilateral shoulder blades, part of the ribs on the right side, thoracic vertebra, lumbar vertebra and pelvis.
表 1 3组一般资料
Table 1. General data among the three groups
Index WB-DWI group (n=25) Multislice spiral CT group (n=25) Combined group (n=30) χ2/t P Age (years, Mean±SD) 56.17±5.25 56.05±5.16 56.11±5.21 0.082 0.917 Disease course (month, Mean±SD) 4.23±1.06 4.18±1.03 4.29±1.11 0.378 0.621 Gender [n(%)] 0.092 0.761 Male 16(64.00) 15(63.75) 18(60.00) Female 9(36.00) 10(36.25) 12(40.00) Durie-Salmon stage [n(%)] 2.337 0.126 I 11(44.00) 9(36.00) 17(56.67) Ⅱ 9(36.00) 10(40.00) 8(26.67) Ⅲ 5(20.00) 6(24.00) 5(16.67) International myeloma stage staging [n(%)] 2.183 0.140 I 12(48.00) 10(40.00) 18(60.00) Ⅱ 7(28.00) 9(36.00) 7(23.33) Ⅲ 6(24.00) 6(24.00) 5(16.67) Disease type [n(%)] 1.087 0.297 Normal type 10(40.00) 9(36.00) 15(50.00) Focal type 5(20.00) 6(24.00) 4(13.33) Dispersive type 3(12.00) 3(12.00) 5(16.67) Mixed type 7(28.00) 7(28.00) 6(20.00) 表 2 WB-DWI、多层螺旋CT单一与联合检测对患者累及部位的检出率对比
Table 2. Comparison of the detection rates of multi-slice spiral CT alone and WB-DWI combined with multi-slice spiral CT for the involved sites [n(%)]
Detection method Pelvis (n=18) Spine (n=24) Ribs (n=11) Skull (n=14) Sternum (n=6) Humerus (n=7) Multislice spiral CT 10(55.56) 13(59.09) 5(45.45) 6(42.86) 1(16.67) 2(28.57) WB-DWI 13(72.22) 17(70.83) 8(72.73) 9(64.29) 3(50.00) 4(57.14) Combined detection 16(88.89) 22(91.67) 10(90.91) 12(85.71) 5(83.33) 6(85.71) χ2 4.985 6.695 5.238 5.600 5.333 4.667 P 0.026 0.010 0.022 0.018 0.021 0.031 表 3 WB-DWI、多层螺旋CT单一及联合对多发性骨髓瘤的检出情况对比
Table 3. Comparison of single and combined detection of multiple myeloma by WB-DWI and multi-slice spiral CT [n(%)]
Pathological findings WB-DWI Multislice spiral CT Combined detection Feminine character Masculine Feminine character Masculine Feminine character Masculine Feminine character 7(61.22) 12(37.84) 6(63.64) 11(32.26) 10(67.19) 13(30.00) Masculine 3(38.78) 3(62.16) 4(36.36) 4(67.74) 3(22.81) 4(70.00) Total 10(40.74) 15(59.26) 10(40.74) 15(59.26) 13(40.74) 17(59.26) 表 4 ROC曲线分析WB-DWI、多层螺旋CT单项及联合对多发性骨髓瘤的诊断价值
Table 4. ROC curve analysis of the diagnostic value of WB-DWI, multi-slice spiral CT and their c-ombination in multiple myeloma
Detection method AUC(95% CI) P Sensitivity (%) Specificity (%) Accuracy (%) WB-DWI 0.767(0.569-0.964) 0.027 73.33(11/15) 80.00(8/10) 76.00(19/25) Multislice spiral CT 0.783(0.584-0.983) 0.018 86.67(13/15) 70.00(7/10) 80.00(20/25) Combination of two terms 0.817(0.626-0.999) 0.008 94.12(16/17) 69.23(9/13) 83.33(25/30) -
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