【摘要】 目的　研究骨髓增生异常综合征 (myelodysplasticsyndromes ,MDS)和急性髓性白血病(acutemyeloidleukemia ,AML)患者股骨骨髓MRI表现 ,评价MRI在MDS诊断、病情评估及预后预测方面的临床应用价值。方法　搜集经临床表现及细胞形态学综合分析诊断为MDS 16例 ,AML 14例 ,行骨盆及股骨中上段骨髓MRI,采用SE及短时反转恢复 (STIR)序列行正冠状面及双侧斜冠状面扫描 ,选取 30例排除血液系统疾病的相对应年龄志愿者作为对照组。搜集MDS及AML患者同期骨髓象及血常规结果和MRI对比分析。结果　患者骨髓MRI表现按浸润程度和范围分为 3级 ,MDS患者 4例属Ⅰ级 ,6例属Ⅱ级 ,6例属Ⅲ级 ;AML患者 8例属Ⅱ级 ,6例属Ⅲ级 ,无Ⅰ级病例。MDS与AML患者MRI分级总体的分布差异无显著性意义 (t =1 388,P >0 0 5 )。比较骨髓率 ,MDS组与AML组同对照组间差异均有显著性意义 (t值分别为 3 0 32和 2 90 5 1,P值均 <0 0 5 ) ;MDS组与AML组骨髓率分级分布差异有显著性意义 (t =8 988,P <0 0 5 )。结合MRI表现及骨髓率评分的MRI分级与临床诊断指标有非常显著一致性 (χ2 =6 2 18,P <0 0 1)。结论　单纯以MRI表现为依据的分级对于鉴别MDS与AML价值有限 ,MRI表现及骨髓率评分相结合的分级标准综合临床资料分析对MDS的诊断、病情评?更多还原

【Abstract】 Objective To observe the MR imaging of bone marrow in myelodysplastic syndromes （MDS） and acute myeloid leukemia （AML）, and to reveal the rule of bone marrow infiltration and the role of MRI in diagnosing and predicting the prognosis of myelodysplastic syndromes.Methods Thirty patients received MRI after the diagnosis based on clinic and FAB subtype study, including 16 with MDS and 14 with AML.MR image was obtained by T₁-weighted spin echo and shot time inversion recovery in pelvis and femur.The examining results of morphology and blood routine were collected at the same time.30 age-matched volunteers were selected as controls. Results The MRI appearance was classified into there patterns based on scope of focus.MRI patterns from grade 1 to grade 3 was observed in patients with MDS.All patients with AML distributed in grade 2 to grade 3.The distribution of patterns had no significant difference between MDS and AML （P>0.05） .The marrow ratio had significant difference among MDS, AML, and controls （P<0.05）.The MRI grade was consistent with the clinic diagnostic indexes.Conclusion MRI can provide a better understanding of the difference between MDS and AML.MRI can estimate the extent of disease in the marrow as a whole.MRI of bone marrow can provide imaging basis in diagnosis and predicting the prognosis for patients with MDS.更多还原