摘要
目的 进一步研究多发性骨髓瘤 (multiplemyeloma ,MM )的MRI表现特点并与X线检查相比较其优缺点 ,同时探讨MRI分型与临床分期的联系。材料与方法 选择 19例经骨髓穿刺证实的MM患者的下胸椎至股骨上段行X线与MRI检查 ,对相同患者相同时间相同部位的X线平片与MRI表现、临床分期、MRI分型与骨髓浆细胞百分比进行比较。结果 MM的MRI据T1 WI骨髓信号减低的形态分为以下类型 :正常型 ,弥漫型 ,局灶型 ,混合型 ,“盐和胡椒”型。腰椎以弥漫型多见占 47.3% ,局灶型、混合型各占15 .8% ;骨盆及股骨近段以局灶型多见占 5 7.9% ,弥漫型占 2 1.1% ,无混合型。MM的X线表现 :未见异常 7例 ,骨质疏松的基础上病理性骨折或骨质破坏 12例。腰椎、骨盆及股骨近段各部位检查的阳性率MRI均为 84.2 % ,X线平片分别为 63.2 %、42 .1%和31.6%。MRI表现 :正常型及“盐和胡椒”型的病例其骨髓浸润较轻 ,均见于临床Ⅰ期MM ,其骨髓浆细胞的百分比较低 ( 8.4± 2 .5 ) ;而弥漫型、局灶型、混合型均见于Ⅱ、Ⅲ期MM ,其骨髓浸润程度相对较重 ,骨髓浆细胞的百分比较高 ( 30 .5± 6.7、45 .2± 11.2 )。结论 MM的MRI表现可分为正常型、弥漫型、局灶型、混合型、“盐和胡椒”型。MRI对MM的敏感性明显高于X线检查 ,但两者的特异性较差?
Objective To study MRI features of multiple myeloma (MM), to evaluate MRI and X ray in the clinical practice, and to investigate the relation between MRI typing and clinical staging.Materials and Methods MRI and radiography of lower thoracic spine, lumbar spine and upper femur were performed in 19 patients with pathologically proved MM. MRI and X ray features were analyzed. A comparison between the imaging findings, clinical staging, MRI typing and the percentage of the plasma cells in bone marrow was made.Results Based on T1WI, MM was classified into the following five types: normal, diffuse, localized, mixed and 'salt with pepper' type. For lumbar spine, diffuse type was most commonly seen (47.3%), while both localized and mixed type were presented in 15.8% of the patients. For pelvis and upper femur, localized type and diffuse type accounted for 57.9% and 21.1 % of the patients, respectively. Mixed type was not encountered. In seven cases, no abnormalities were demonstrated. Pathologic fracture or bone destruction was displayed on radiographs in 12 patients. The sensitivity in detecting the lesions on radiographs of lumbar spine, pelvis and upper femur was 63.2%, 42.1% and 31.6%, respectively, while it was 84.2% on MRI for all the above three areas.Conclusion On MRI, MM can be classified into five types: normal, diffuse, localized, mixed and 'salt with pepper' type. MRI is more sensitive than conventional radiography in detecting bone lesions of MM. MRI is helpful in guiding bone marrow puncturing as well as in making clinical staging and prognosis.
出处
《临床放射学杂志》
CSCD
北大核心
2001年第9期696-699,共4页
Journal of Clinical Radiology
