Comparison Of IVIM Parameters Between Benign And Malignant Myeloproliferation And Its Histological Significance

Objective:To analyze the assessment of ADC,D,D* and ? parameters by Multi-b DWI technique based on intravoxel incoherent motion?IVIM?in patients with hyperplastic anemia and acute leukemia?AL?before standardized treatment.To the investigate the correlation among IVIM parameters?bone marrow pathology?serum changes and age.Methods:In total,from 2016 August to 2017 February,43 patients with AL and hyperplastic anemia were diagnosed by pathology in department of Hematology of The second hospital of Shanxi Medical University were recruited in this study.Among them,there were 28 patients with AL and 15 patients with hyperplastic anemia.1.All patients underwent MR imaging of lumbar vertebral bone marrow using 1.5T superconducting magnetic resonance scanner.Our MR imaging study included the sequence of sagittal T1-weighted,conventional DWI?b=0,500s/mm²?,and Multi-b DWI?b=0,10,25,50,100,200,400,600,800,1000,1200s/mm²,gradually increased by a total of 11 b values?.The ADC value,D,D* and ? values of lumbar vertebrals?L2–L4?were measured by Functool and MADC software.2.Collected All patients blood samples about 1ml,centrifuged then extracted the serum,and placed at-80?.The serum levels of vascular endothelial growth factor?VEGF?were detected by Human VEGF ELISA Kit of Boster.3.Microvascular density?MVD?was counted with CD34.First at the low power magnificatioon?10×10?to find the highest vascular density of the region,known as the "hot spots",and then at high power magnificatioon?10×20?to count the number of blood vessels,select three field of view to read the average value.Comparison of ADC,D,D* and ? values in AL group and proliferative anemia group.The area under the ROC curve was used to assess the ability of each parameter to evaluate benign and malignant myeloproliferative diseases.The correlation between the parameters of IVIM and VEGF,MVD and age was analyzed.Results:1.The value of D?f?D*showed significant differences?P<0.05?.D* and D value of AL group was significantly lower?P<0.01?,and f value was significantly higher?P=0.01?than hyperplastic anemia group.There was no significant difference in the value of ADC between AL group and hyperplastic anemia group?P=0.18?.2.Using ROC analysis AL and hyperplastic anemia patients,we can see that AUCD=0.880,sensitivity was 0.964,specificity was 0.667,the critical point is D=0.28×10^-3mm²/s;AUCf=0.776,sensitivity was 0.679,specificity was 0.800,the critical point is f=24.93%;AUCD*=0.917,sensitivity was 0.964,specificity was 0.733,the critical point is D*=9.75%.There is a certain value in D?f?D*values in the evaluation of benign and malignant diseases.3.Analysing the correlation among MVD?VEGF?D?f and D*,the f showed significantly statistical correlations with MVD?r=0.419?and VEGF?r=0.407?;the D* has statistical correlations with MVD?r=-0.512?and VEGF?r=-0.418?;the D has statistical correlations with MVD?r=-0.407?and VEGF?r=-0.443?.The value of ADC?r=0.197??D?r=0.955??f?r=0.533?and D*?r=0.060?showed no significant correlation with age.Conclusion:The multi-b DWI technique based on IVIM has some research value for the diseases assessment,so it is possible to evaluate the prognosis of patients with noninvasive.When f>24.93%,D<0.28×10^-3mm²/s,D*<9.75%,it is more likely to be malignant diseases.IVIM is associated with MVD and VEGF,which can reflect the angiogenesis of bone marrow.The value of f showed positive correlation with MVD and VEGF.The value of D?D* showed negative correlation with MVD and VEGF.The value of ADC?D?f and D* showed no significant correlation with age.