全身弥散加权成像（WB-DWI）在初诊多发性骨髓瘤患者中的诊断和监测作用

OBJECTIVE: To explore the practical value of whole-body diffusion weighted imaging (WB-DWI) in the diagnosis and monitoring of newly diagnosed multiple myeloma (MM) patients. METHODS: The clinical data of 107 newly diagnosed MM patients at hematology department of the first affiliated hospital of Soochow's University from September 2012 to January 2016 were retrospectively analyzed. The results of all the 60 patients who were performed WB-DWI before treatment were analyzed. And the role of WB-DWI in the diagnosis and monitoring MM was discussed. RESULTS: Of 60 patients, 57 were found to have more or less abnormal foci of osteoclasia by WB-DWI with the positive rate of 95.0% (57/60). Myeloma related bone lesions occurred predominantly in the axial skeleton, which were commonly seen in ribs, spines and pelvis. There were 96.5% (55/57) patients who had osteolytic rib lesions. And the ribs were the most vulnerable organs. Thirteen patients who had no osteoclasia by computerized tomography (CT) examination were detected abnormal limited diffuse lesions by WB-DWI. Eight patients underwent more than one follow-up WB-DWI. The mean apparent diffusion coefficient (ADC) values of the maximal lesions from all eight patients before and after treatment were 0.984×10(−3)mm(2)/s and 1.142×10(−3)mm(2)/s, respectively. They were both higher than the normal range [(0.516±0.180) ×10(−3)mm(2)/s]. Mean ADC values of the maximal lesions after treatment were higher than that before treatment. The results of WB-DWI after the induction chemotherapy were consistent with clinical therapeutic effect. CONCLUSION: WB-DWI has an important value in the diagnosis and monitoring of newly diagnosed MM. It has higher sensitivity than than that of CT. The results of WB-DWI after induction therapy has a nice correlation with treatment effect and it could monitor the disease.