| Objective:Magnetic resonance imaging water-fat separation(Dixon)technology has important clinical value in the diagnosis,treatment and prognosis evaluation of Multiple myeloma(MM).To further explore the application value of this technique and the quantitative index FF obtained by image post-processing software in multiple myeloma,this study analyzed the differences of laboratory indexes and FF of newly diagnosed multiple myeloma patients with different imaging manifestations,as well as the correlation between FF and patients’ clinical features,laboratory indexes,disease stages and differences before and after treatment.Intending to further study the clinical significance of FF combined with serum alkaline phosphatase in multiple myeloma patients.Methods:A total of 41 newly diagnosed patients with multiple myeloma who underwent magnetic resonance imaging water-fat separation(Dixon)technology in the Affiliated Hospital of Qingdao University were collected and included in this study in two years.Patients were divided into groups according to whether Dixon’s performance was normal or not.Patients with abnormal Dixon’s performance were divided into observation group and normal patients into control group.The clinical data such as staging,fat fraction,percentage of myeloma cells,β2 microglobulin,M protein,alkaline phosphatase and so on were collected.Using SPSS25.0 statistical software and intra-group correlation coefficient(ICC),the consistency of FF values measured twice was tested.Compare the clinical data and FF between the two groups.The correlation between FF and clinical data and disease stages was compared in all patients and each group.Among the 13 patients who completed 4 cycles of complete chemotherapy,the chemotherapy plan and clinical data after treatment were counted,and the curative effect was evaluated according to the curative effect judgment standard proposed by the International Myeloma Working Group,and the differences were compared.Draw the receiver operating characteristic curve(ROC)curve to evaluate the diagnostic value of FF and serum alkaline phosphatase for bone destruction in MM patients.P<0.05 was statistically significant.Result:1.Among the 41 patients,there were 12 cases in the control group and 29 cases in the observation group.The concentration of β2 microglobulin and M protein in both groups were higher than those in the normal range.In the observation group,the β2 microglobulin concentration and M protein in blood were significantly higher than those in the control group(P<0.05),while the FF and serum alkaline phosphatase level were significantly lower than those in the control group(P<0.05).There was no significant difference in the percentage of myeloma cells,blood calcium,creatinine,lactate dehydrogenase,hemoglobin and other clinical data in this study between the observation group and the control group(P>0.05).2.In 41 patients,there was a significant negative correlation between FF and β2microglobulin concentration(r=-0.57),and there was a significant positive correlation between FF and serum alkaline phosphatase(r= 0.31),but there was no significant correlation with other clinical data.And there was no significant correlation between FF and other clinical data in these two separate groups.(P>0.05).3.In 41 patients,there was no significant correlation between clinical stage and FF(P>0.05).Among 29 patients with MM in the observation group,there were 4 patients with R-ISS stage I,16 patients with R-ISS stage II and 9 patients with R-ISS stage III.The FF of patients with R-ISS stage III was significantly lower than that of R-ISS stage II(P<0.05),However,there was no significant difference in FF between R-ISS stage I and stage III,and between stage I and stage II(P>0.05),and there was no significant difference in FF between stages of ISS(P>0.05).4.13 patients successfully completed four cycles of treatment,and all the treatment schemes included triple chemotherapy schemes including bortezomib,a new proteasome inhibitor.Different treatment schemes were effective,and the lesion area was reduced by reexamining imaging.Comparing the clinical data at the time of initial diagnosis and after treatment,the results showed that after treatment,the percentage of myeloma cells,the concentration of M protein and β2 microglobulin decreased to varying degrees,while the FF increased compared with that before treatment,and the difference before and after treatment was statistically significant(P<0.05)5.The area under the bone destruction curve predicted by the FF of magnetic resonance water-fat separation technology and serum alkaline phosphatase was 0.987 and 0.734,respectively,the sensitivity was 1.00 and 0.83,and the specificity was 0.93 and 0.69,respectively.The area under the bone destruction curve predicted by the two methods was0.993,the sensitivity was 1.00 and the specificity was 0.97,and when the FF value is lower than 89.73 and the serum alkaline phosphatase is lower than 72.35,there is a potential risk of bone destruction in patients.Conclusion:1.There are significant differences in β2 microglobulin concentration,M protein,FF value and alkaline phosphatase between normal group and abnormal group,suggesting that different imaging manifestations of Dixon can reflect the severity of the disease.Patients with abnormal imaging findings are often relatively serious.2.There is a correlation between FF value and β2 microglobulin concentration,serum alkaline phosphatase and R-ISS stage,which suggests that FF can reflect the severity and prognosis stratification of the disease to a certain extent,and it is of significance to guide the prognosis.3.After treatment,the FF value of patients increased significantly,and the plasma cell ratio,β2 microglobulin and M protein decreased to varying degrees.After effective treatment,the condition of patients with abnormal Dixon can be effectively controlled.Therefore,this technique has the value of evaluating the curative effect,and FF value can be used as one of the monitoring indexes of curative effect.4.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.When FF value and serum alkaline phosphatase are lower than the critical value,even if there is no abnormal manifestation in imaging,there is the possibility of bone destruction... |
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