脊柱孤立性浆细胞瘤的X线、CT和MRI表现

The Clinical Imaging Performances of Solitary Plasmacytoma of Spine

目的:分析脊柱孤立性浆细胞瘤的X线、CT和MRI表现,提高对浆细胞瘤的认识与诊断准确率。材料和方法:回顾性分析5例经临床病理证实的脊柱孤立性浆细胞瘤病例,总结分析影像学表现。结果:所有病灶均为单发椎骨受累,其中胸椎3例,腰椎2例,3例发生椎体压缩性骨折。X线及CT多表现为穿凿样溶骨性破坏、膨胀性生长及软组织肿块,MRI信号具有多样性,增强扫描呈明显增强。结论:X线平片对脊柱孤立性浆细胞瘤的诊断敏感性较低,有助于排除多发骨髓瘤;CT及MRI可明确脊柱孤立性浆细胞瘤的病灶范围及形态特征,CT较MRI更能清晰地显示瘤体内增厚的骨小梁或残存的骨质,MRI检查则为该病的诊断、鉴别、分期提供诸多信息,是该病最佳的诊断方法。

Purpose： Analysing the imaging performance of solitary plasmacytoma of spine, to raise the awareness and the diagnosis accuracy. Materials and Methods： Five cases of spinal solitary plasmacytoma confirmed by clinical pathology were retrospectively analysed, to sum up the imaging performance characteristics. Results： All lesions were single vertebra involved ,3 cases in thoracic and 2 eases in lumbar, 3 cases occurred vertebral compression fracture. X-ray and CT showed osteolytic destruction, expansive growth and soft tissue mass, MRI showed diversity of signals, and remarkable enhancement after contrast injection. Conclusions ： X-ray presents lower diagnostic sensitivity, but contributes to exclude multiple myeloma. CT and MRI can depict the morphological features and extent of tumor regions definitely, CT shows better than MRI on the thickening trabecula and residual bone in the tumor, MRI can provide a lot of information for plasmacytoma, including the diagnosis, identification and staging, which is considered as the best imaging diagnostic methods of plasmacytoma.