IgG型多发性骨髓瘤的X线及CT表现

Xray and CT Features of IgG Multiple Myeloma

目的：探讨ＩｇＧ型多发性骨髓瘤（ＭＭ）的Ｘ线及ＣＴ表现。材料与方法：经骨髓涂片或活检、免疫学检查，确诊为ＩｇＧ型ＭＭ患者１６例，对其Ｘ线及ＣＴ影像进行分析及总结。结果：ＩｇＧ型ＭＭ好发于红骨髓部位，主要征象为骨破坏（类圆形，膨胀形及不规则３型）、骨折、骨疏松。膨胀性骨破坏好发于肋骨，ＣＴ显示骨破坏处为软组织替代，可有完整或不完整骨壳，对邻近结构仅为外压而无浸润表现，治疗后可修复。结论：骨髓瘤细胞在骨髓内生长呈灶性或弥漫性，其与Ｘ线及ＣＴ表现、检查方法之选择及预后关系密切。诊断不明确时应采用ＭＲＩ、ＣＴ检查。ＩｇＧ型ＭＭ易感染的特点。

Objective: To study the Xray and CT features of IgG multiple myeloma (IgG MM). Materials and Methods: The Xray and CT features of 16 cases with IgG multiple myeloma, proved by immunological test and bone marrow aspiration or biopsy, were analyzed. Results: IgG MM mainly invaded red marrow. The most common manifestations were bone destruction (round, expansive or irregular in shape), fracture and osteoporosis. Expansive destruction was commonly seen in ribs. On CT scan the destruction was replaced by the soft tissue, which had an intact or incomplete bony shell and pressed adjacent structures without any infiltration. The lesions regressed after properly treated. Conclusion: Bone marrow involvement may be focal or diffuse, and thus has different Xray and CT features. Examination method should be properly selected in order to clearly show lesion's shape and extent. MRI and CT should be used for doubtful cases. Radiological signs due to infection should be carefully searched on imaging examination as