Application Value Of Dual-Energy CT Virtual Non-Calcium Technique In Quantitative Evaluation Of The Degree Of Bone Marrow Infiltration In Patients With Multiple Myeloma

Multiple myeloma(MM)is a kind of plasma cell malignant tumor disease,in which a large number of plasma cells in the bone marrow proliferate abnormally and secrete immunoglobulin,resulting in the injury of corresponding tissues or organs.X-ray and conventional CT are sensitive to the changes of the bone cortex and can show the hyperplasia or destruction of the bone cortex.However,the detection ability of bone marrow lesions is poor.At present,MRI examination is mainly performed for myelopathy,which is a non-invasive examination with high sensitivity to detect myelopathy,and has opened a new prelude to the diagnosis of bone marrow diseases.In recent years,magnetic resonance imaging(MRI)has become a important auxiliary examination of MM comprehensive check and gradually applied in clinical,main parameters including DWI bone marrow signal strength(SI),the signal intensity ratio(SIR)and apparent diffusion coefficient(ADC)etc,however,its cost is higher and the inspection time is longer;while Dual energy CT(DECT)has short check time and is convenient,it utilizes virtual non-calcium(VNCa)technology to detect myelopathy with high sensitivity and specificity,enabling visualization of bone marrow imaging,which is comparable to MRI and provides important value for clinical diagnosis and treatment as well as scientific research.Objective:To explore the diagnostic performance of DECT-VNCa technique on bone marrow infiltrating lesions in MM patients and the correlation between virtual non-calcium(VNCa)attenuation values and MRI parameters.Methods:In this prospective study,34 patients with MM who were admitted to our hospital from September 2021 to February 2023 and confirmed by clinical serological examination and bone marrow puncture biopsy were selected as subjects,and 31 healthy volunteers were included as control group.The difference of virtual non-calcium(VNCa)attenuation values between the case group and the normal group was compared and analyzed,and the diagnostic ability of VNCa for MM bone marrow infiltrating lesions was evaluated,and the critical value of virtual non-calcium(VNCa)attenuation values between the case group and the control group was further explored.The correlation between virtual non-calcium(VNCa)attenuation values and MRI parameters(SI,SIR And ADC values)was also evaluated.Results:1.Virtual non-calcium(VNCa)attenuation value of MM case group was-17.45(-26.83,16.57)HU,and that of control group was-50.50(-70.94,-39.02)HU.There was a statistically significant difference between them(Z=-9.599,P<0.001).2.Virtual non-calcium(VNCa)attenuation values in MM case group were positively correlated with SI,SIR And ADC values(Rs=0.441,Rs=0.412,Rs=0.492).Conclusions1.DECT-VNCa bone marrow imaging has high diagnostic efficacy in MM bone marrow infiltrating lesions.2.There was a good correlation between the virtual non-calcium(VNCa)attenuation value of bone marrow infiltrating lesions in MM patients and MRI parameters,indicating that for patients unable to perform MRI examination,DECT-VNCa technology can be used as an imaging method for quantitative evaluation of bone marrow infiltrating degree in MM patients,which has important application value.3.Diagnostic efficacy of VNCa: The AUC of VNCa in the diagnosis of MM bone marrow infiltrating lesions was 0.898,and the difference between AUC=0.5 was statistically significant(Z=17.732,P<0.001).When the virtual non-calcium(VNCa)attenuation value was >-36.56 HU,the sensitivity was 87.25%,and the specificity was 80.65%.