| Objective: To assess the microstructure of marrow using the parameters of IVIM, then to investigate gender-related cellular and capillary network in marrow of healthy young adults. To discriminate the microstructure of marrow in patients with AML from ALL, and to evaluat cellularity, vascular volume and blood velocity of patients’ bone marrow of AL with IVIM parameters.Methods: 60 healthy young adults(30 males and 30 females) and 40 cases patients with acute leukemia newly confirmed by bone marrow aspiration and pathologically(20 cases of AML, 20 cases of ALL) underwent MRI scans at 1.5T using a conventional DWI and a IVIM(b= 0,10,25,50,100,200,400,600,800,1000, 1200s/mm2) sequence on sagittal planes covering the lumbar bone marrow. Measuring data uses Sun AW4.4 workstation, and then comparing the parameter value of males to females, and the parameter value differences between AML and ALL patients.Results: Obtaining average parameter value of 2-4 lumbar vertebrae of healthy volunteers. The D value [(0.28±0.04)×10-3mm2/s] in females was higher than that [(0.20±0.04)×10-3mm2/s] in males, the difference was statistically significant(t=-8.653, P=0.001), however, the ADC value was not statistically significant between female and males(t=-1.337, P=0.186). The f value was significantly higher in females(31.70±3.65%) compared with males(28.94±5.52%; t=-2.286, P=0.026), however, D* value was significantly lower in females [(46.72±12.90)×10-3mm2/s] than that [(91.78±30.83)×10-3mm2/s] in males(t=7.387, P=0.001). The D, f and D* value were not significant difference among second, third and fourth lumbar vertebras of females(t=0.022, P=0.978; t=0.942, P =0.397; t=0.445, P=0.642, respectively), there also were not significant difference in males(t =0.370, P =0.691; t=0.326, P=0.723; t=0.634, P=0.533, respectively).Obtaining average parameter value of 2-4 lumbar vertebrae of acute leukemia(AL). The D value [(0.24±0.06)×10-3mm2/s] in patients with ALL was higher than that [(0.19±0.03)×10-3mm2/s] in patients with AML, the difference was statistically significant(t=-3.363, P=0.002), however, the ADC value was not statistically significant between female and males(t=-1.891, P =0.070). The f value was significantly higher in patients with ALL(24.06±8.67%) compared with patients of AML(18.71±5.27%; t=-2.377, P=0.023), however, D* value was significantly lower in patients with ALL [(53.88±22.16)×10-3mm2/s] than that [(95.24±29.36)×10-3mm2/s] in patients of AML(t=5.028, P=0.001). The AUC(Area Under Curve) of D, D*, f values in discriminating ALL from AML were respectively 0.77, 0.89 and 0.68. The optimal diagnostic threshold of D, D*, f values in identifying ALL from AML were respectively 0.21×10-3mm2 /s, 64.16×10-3mm2/s and 19.18%, sensitivity were respectively 75%, 90% and 65%, specificity were respectively 75%, 80% and 65%.Conclusion: IVIM parameters can show the microstructure of marrow in younger females and males compared with the ADC values. Their cellularity and hemodynamic characteristics of bone marrow are different. IVIM parameters of patients with AL show that AML and ALL marrow microstructures are different. The D* value have the highest value to discriminate AML and ALL. |
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