脊椎多发性骨髓瘤影像检查方法对比研究

目的研究脊椎多发性骨髓瘤的平片、CT、MRI和核素扫描表现,比较各种检查方法的优点和缺点,以提高对脊椎多发性骨髓瘤的认识和诊断水平。方法分析40例经病理证实的脊椎多发性骨髓瘤影像学资料,全部病例均同期行X线平片、CT、MRI和核素扫描检查。由2位有经验的骨关节放射诊断医师和2名核医学医师采用双盲法独立阅片,观察、分析和记录各种检查征象。结果在40例病人169个病变椎骨中:X线发现25例65枚椎骨,31枚附件受累,50枚可见压缩骨折。CT发现32例118枚椎骨,MRI发现36例169枚椎骨,ETC发现34例113枚椎骨。对比四种检查方法,MRI对脊椎多发性骨髓瘤的显示敏感性和对病变特点的显示最好。结论 MRI具有较高的敏感性和特异性,可作为主要检查方法。

Objective Through investigate X-ray, CT, MR/and SPECT imaging features of the spinal multiple myeloma （MM）, compare the 4 examine methods with each other, in order to improve the diagnostic level of MM. Methods To analyze the imaging features of 40 patients confirmed pathologically. All patients were examined by X-ray, CT, MRI and SPECT in the same period. Two salty bone-radiology doctors and two nuclear medicine doctor read the film all alone by double blind method, to observe, analyze and record various imaging features.Results 169 vertebrae were found in 40 patients. 65 vertebrae in 25 patients were found in X-ray. 31 vertebrae with appendix involvement, 50 vertebrae with compression fracture. 118 vertebrae in 32 patients were found in CT. 169 vertebrae in 36 patients were found in MR. In addition, normal type amounted to 4 patients. Comparing with the other methods, MR/has the highest sensitivity and accuracy. Conclusion MR/has the best sensitivity and accuracy for MM, so it may be the main diagnostic method.