骨髓瘤影像学诊断

Imaging diagnosis of myeloma

目的:探讨骨髓瘤影像表现及诊断价值。方法:回顾性分析23例经骨髓穿刺或手术病理证实的骨髓瘤影像表现。23例患者均行相应部位X线检查,19例行CT检查,9例行MRI检查。结果:2例单发性骨髓瘤股骨、骨盆各1例。21多发性骨髓瘤,主要侵犯头颅18例,胸椎17例,腰椎15例,肋骨3例,骨盆2例。在X线片上,1例正常,4例骨质疏松,18例骨质破坏;CT示100%均有骨破坏,12例伴软组织肿块;9例脊椎MRI均示病变呈长T1,长T2信号。结论:X线对骨髓瘤的检查有重要作用,椎体多骨多灶性破坏、长骨溶骨性破坏等对本病有重要诊断价值。CT对本病的骨质破坏、软组织侵犯等观察优于X线。MRI对骨髓瘤侵犯性破坏所致的早期骨质改变,以及发现骨髓的早期侵犯优于X线和CT。

Objective：To explore the imaging diagnosis of myeloma. Methods： Twenty-three myeloma verified by biopsy or by pathology were analyzed retrospectively. Twenty-three cases were examined by X-ray, 19 cases were also checked by CT and 9 cases examined by MRI. Results：In 2 cases of the solitary myeloma was in the femur and pelvis. In 21 cases of multiple myeloma, Skull bone were found in 18, thoracic vertebrae in 17, lumbal vertebrae in 15, ribs in 3, pelves in 2. On X-ray films 1 cases were normal, 4 cases osteoporosis, 18 cases bony destroy. On cr 100% had ostcolytic lesions with a soft tissue mass in 12 cases. No clear periosteal reaction was observed on CT. On MR/of the spine 9 eases had long T1 and long T2 signal lintens. Conclusion：X-ray examination plays an important role in the diagnosis of the myeloma. Its characteristics are multiple level vertebral body involvement and muhifocal destruction, osteolytic mullifocal destruction of long bones. Compared with X-ray, cr can more clearly discern the lesions such as destruction of bone,the invasion of soft tissues. Compared cr and X-ray, MRI can more clearly identify the lesions such as the early changes of bone mineral content invaded by myeloma and the early involvement of bone marrow.