中文摘要：

目的探讨磁共振全身弥散加权成像（wB—DWI）在初诊多发性骨髓瘤（MM）患者诊断和监测中的应用价值。方法收集2012年9月至2016年1月收治的107例初诊MM患者的临床资料，分析其中治疗前行WB．DWI检查的60例患者的结果，探讨WB—DWI在MM诊断和监测中的作用。结果60例患者中有57例均发现程度不等的骨质破坏病灶，WB．DWI阳性检出率为95．0％（57／60）。MM相关的骨破坏多累及中轴骨，以肋骨、脊柱及骨盆骨多见，肋骨为最易受累部位，检出率为96．5％（55／57）。有13例患者初诊时CT检查未发现骨质破坏，但行WB—DWI检查发现相同部位有弥散受限病灶影。8例患者治疗前后均行WB—DWI检查，结果显示8例患者治疗前最大病灶的中位表观弥散系数（ADC）值为0．984x10^-3mm。／s；治疗后为1．142×10^-3mm。／s，治疗后最大病灶的中位ADC值较治疗前高，且均高于正常值[（0,516±0．180）×10^-3mm2／s]；诱导治疗后WB．DWI检查结果与临床疗效相符。结论WB．DWI在诊断和监测MM中起重要作用，其诊断敏感性优于CT；诱导治疗后的WB—DWI检查结果与患者的临床疗效有一定的相关性，可用于疾病监测。

英文摘要：

Objective To explore the practical value of whole-body diffusion weighted imaging （WB-DWI） in the diagnosis and monitoring of newly diagnosed multiple myeloma （MM） patients. Methods The clinical data of 107 newly diagnosed MM patients at hematology department of the first affiliated hospital of Soochow＇ s University from September 2012 to January 2016 were retrospectively analyzed. The results of all the 60 patients who were performed WB-DWI before treatment were analyzed. And the role of WB-DWI in the diagnosis and monitoring MM was discussed. Results Of 60 patients, 57 were found to have more or less abnormal foci of osteoclasia by WB-DWI with the positive rate of 95.0% （57/60）. Myeloma related bone lesions occurred predominantly in the axial skeleton, which were commonly seen in ribs, spines and pelvis. There were 96.5% （55/57） patients who had osteolytic rib lesions. And the ribs were the most vulnerable organs. Thirteen patients who had no osteoclasia by computerized tomography （CT） examination were detected abnormal limited diffuse lesions by WB-DWI. Eight patients underwent more than one follow-up WB-DWI. The mean apparent diffusion coefficient （ADC） values of the maximal lesions from all eight patients before and after treatment were 0.984x 10-3mm2/s and 1.142 x 10-3mm2/s, respectively. They were both higher than the normal range [ （0.516-0.180） x 10-3mm2/s ]. Mean ADC values of the maximal lesions after treatment were higher than that before treatment. The results of WB-DWI after the induction chemotherapy were consistent with clinical therapeutic effect. Conclusions WB-DWI has an important value in the diagnosis and monitoring of newly diagnosedMM. It has higher sensitivity than than that of CT. The results of WB-DWI after induction therapy has a nice correlation with treatment effect and it could monitor the disease.