Objective: To explore the clinical significance of magnetic resonance imaging water-fat separation (Dixon) technique in patients with multiple myeloma.
Methods: A total of 41 newly diagnosed patients with multiple myeloma who underwent Dixon in The Affiliated Hospital of Qingdao University from April 2019 to April 2021 were included in this study. Patients were divided into observation group and control group according to whether Dixon performance was normal or not. The differences of clinical data and fat fraction (FF) between the two groups were compared. The correlation between FF and clinical data, disease stages and differences before and after treatment were also compared. The receiver operator characteristic curve of patients was drawn to analyze the diagnostic value of FF combined with serum alkaline phosphatase for bone destruction in patients with multiple myeloma.
Results: Among the 41 patients, there were 12 cases in the control group and 29 cases in the observation group. There was no significant difference in age and sex between the two groups. In the observation group, β2-microglobulin concentration and M protein were significantly higher than those in the control group, while serum alkaline phosphatase and FF were lower (P<0.05). In all 41 patients included in the study, there was a significant negative correlation between FF value and β2-microglobulin concentration (r=-0.57), and a significant positive correlation between FF value and serum alkaline phosphatase (r=0.31). After treatment, FF value increased, while myeloma cell percentage, β2-microglobulin concentration and M protein decreased in 11 patients who completed 4 cycles of chemotherapy, and the differences before and after treatment were statistically significant (P<0.05). The value of serum alkaline phosphatase combined with FF value in predicting bone destruction is higher than that of FF value or serum alkaline phosphatase alone.
Conclusion: Dixon's different imaging manifestations can reflect the severity of the disease. FF value is correlated with clinical examination results and R-ISS staging, and there is a significant difference before and after treatment. Serum alkaline phosphatase combined with FF value is better than two indicators alone in predicting bone destruction.
题目: 磁共振成像水脂分离技术在多发性骨髓瘤患者中的应用研究.
目的: 探讨磁共振成像水脂分离（Dixon）技术在多发性骨髓瘤患者中应用的临床意义.
方法: 将2019年4月至2021年4月于青岛大学附属医院行Dixon技术检查的初诊多发性骨髓瘤患者共41例纳入本研究。将患者按照Dixon表现是否正常分为观察组和对照组，比较两组患者临床资料、脂肪分数（FF）值的差异，比较FF与临床资料、疾病分期之间的相关性及治疗前后的差异，并绘制受试者工作特征曲线，分析FF联合血清碱性磷酸酶对多发性骨髓瘤患者骨质破坏的诊断价值.
结果: 41例患者分为对照组12例、观察组29例，两组间年龄、性别差异均无统计学意义。观察组β2-微球蛋白浓度、M蛋白均显著高于对照组，而血清碱性磷酸酶及FF均低于对照组（P<0.05）。在纳入研究的全部41例患者中，FF值与β2-微球蛋白浓度之间存在显著负相关（r=-0.57），与血清碱性磷酸酶存在显著正相关（r=0.31）。11例经过4疗程化疗的患者治疗后FF值升高，骨髓瘤细胞百分比、β2-微球蛋白浓度、M蛋白降低，治疗前后的差异有统计学意义（均P<0.05）。血清碱性磷酸酶联合FF值预测骨质破坏的价值高于二者单独应用.
结论: Dixon的不同影像学表现能够反应疾病的严重程度，FF值与临床检查结果及R-ISS分期之间存在相关性，且治疗前后有显著差异，血清碱性磷酸酶联合FF值预测骨质破坏优于两项指标单独应用.
Keywords: fat fraction; magnetic resonance imaging; multiple myeloma; water-fat separation.