脊柱孤立性浆细胞瘤的影像学表现

Imaging Findings of Solitary Plasmacytoma in 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和诊断水平。资料与方法回顾性分析16例经临床病理证实的脊柱孤立性浆细胞瘤,总结分析其影像学表现。结果 16例脊柱孤立性浆细胞瘤患者年龄36～69岁(平均54岁),男女比例3∶1,1例发生在颈椎,10例发生在胸椎,5例发生在腰椎,病程从半个月到3年不等,病椎附近疼痛是共同的首发症状。X线和CT表现为脊椎单发溶骨性破坏,椎体膨胀性改变,边界清晰,无骨膜反应,可残存较厚的骨嵴。MRI表现为T1低等信号,T2高信号,增强扫描均匀强化,MRI可以更加清晰地显示软组织肿块,局限性终板骨折,椎管受累及脊髓受压。结论 X线平片表现为单发病变,膨胀性溶骨性破坏,无骨膜反应,X线检查可以作为孤立性浆细胞瘤的初筛。CT和MRI可以明确脊柱孤立性浆细胞瘤的病变范围和形态特征,为该病的诊断、鉴别提供更多的信息,溶骨性病变、软组织肿块、椎弓根、椎间盘及相邻椎体受累是病变的主要表现。

Objective To analyze the radiologic features of solitary plasmacytoma in spine.Materials and Methods The radiologic features of 16 cases with solitary plasmacytoma of spine confirmed by pathology were analyzed retrospectively.Results All the tumours were primarily located in the vertebrae（including 1cases in cervical vertebrae,10 cases in thoracic vertebrae and 5 cases in lumber vertebrae）.The male to female ratio was 3：1.The age of the patients ranged from 36 to 69（mean age=54 years）.The common symptom was pain in the surrounding regions.Solitary lytic bone destruction,well-defined margin,no periosteum reaction were seen on X ray film.There was hypointensity signal on T1W and hyperintensity signal on T2W with homogenous enhancement.Conclusion CT and MRI can depict the morphological features and extent of regions clearly,MRI can provide a lot of information for diagnosis of plasmcytoma