Dynamic Contrast-enhanced Magnetic Resonance Imaging Of Bone Marrow Infiltration At Different Location In Patients With Acute Leukemia

Objectives: To evaluate the Dynamic enhancement of bone marrow MRI (DCE-MRI) formonitoring the treatment response in the patients with acute leukemia by comparatively analysisthe bone marrow perfusion parameters and the blast cell proportion in histopathology.Methods: In this study,we performed bone marrow DCE-MRI with FLASH sequenceT1WI at diagnosis and after chemotherapy in 47 acute leukemia(AL)patients and divided intothree groups:onset,complete remission and progressive. The percentage enhancementtime-signal intensity curves(TIC)was draw in region of interest(ROI)of iliac and lumbarvertebra. The maximum enhancement (ME) and the enhancement slop (ES) were evaluated. Allof the patients were examined with iliac crest biopsy from the posterior superior iliac crests afterthe MR examination. The pathological specimens analyzed with blast cell proportion.Descriptive statistical data were expressed as mean±standard deviation. AVON analysiswas used to compare the differences of the ME and ES among the onset AL patients and thecomplete remission patients and the disease progressive patients. Correlation between perfusionparameters and histopathological result was assessed using SPSS16.0 software package. P valuesof 0.05 or less was considered significant.Results:1. In all patients of acute leukemia include onset and after treatment,the ME value of thebilateral iliac were slightly higher than the lumbar vertebral(P=0.001). There is no significantdifference in ES value between the bilateral iliac and the lumbar vertebral(P=0.593).2. The ME and ES values were decreased significantly in both iliac and lumbar vertebral atremission status after induction chemotherapy(P<0.05). There is no significant differencebetween onset patients and progressive patients(P>0.05).3. A significant positive correlation was found between perfusion parameters and the blastcell proportion in the bone marrow.Conclusions: Dynamic contrast enhanced magnetic resonance imaging can provide thechange of functional and hemodynamic of tumor angiogenesis. The ME value of the bilateraliliac are higher than the lumbar vertebral indicated the correlation of cellularity with angiogenesis.We found that there is a positive correlation between perfusion parameters and the blast cell proportion in the bone marrow. Our findings provide evidence that decreased bone marrowangiogenesis measured by DCE-MRI can predict good clinical outcome in AL patients.