淋巴瘤骨髓的MRI表现

MRI of lymphoma of bone marrow

目的 研究骨淋巴瘤的MRI表现 ,探讨其MRI诊断的价值。方法 10例骨淋巴瘤 ,男8例 ,女 2例 ,年龄 11～ 75岁 ,平均 35 6岁。 10例均行MRI检查。原发性霍奇金病 (Hodgkin′sdisease,HD)和非霍奇金淋巴瘤 (non Hodgkin′slymphoma,NHL)各 1例 ,继发性B细胞源性NHL 8例。结果(1)发病部位 :8例继发性者累及腰椎 6例次 ,胸椎 5例次 ,骶尾椎 4例次 ,骨盆 3例次 ,股骨近端、肋骨、颅骨、胸骨各 1例次。 2例原发性HD和NHL分别累及胸腰椎和胸椎 ;(2 )病灶数目 :8例继发性者均多骨多发 ,2例原发性HD和NHL分别为多骨多发和单骨发病 ;(3)MRI信号 :骨髓异常表现为长T1长T2 信号 ,软组织肿块表现为等T1、略长T2 信号 ;(4 )病灶形态 :9例呈多发灶状、斑片状改变 ,1例原发性HD呈弥漫性改变 ;(5 )病理性骨折及软组织肿块 :3例合并椎体病理性骨折 ,6例合并软组织肿块。结论 骨淋巴瘤以继发性NHL为主 ,主要侵犯中轴骨 ,多呈多发局灶性、斑片状长T1长T2 信号。MRI检查敏感性高 ,但缺乏特异性。

Objective To study MRI manifestation of lymphoma of bone marrow. Methods Ten patients(8 males and 2 females) with lymphoma of bone were performed MRI. Two cases were primary (1 HD and 1 NHL) and 8 were secondary NHL. Results (1)Location: All cases involved axial bones; (2)Number: 9 cases involved multiple bones, only 1 primary NHL involved solitary bone; (3)Signal Intensity: The marrow infiltration were showed low and high signal intensity on T 1WI and T 2WI respectively; (4)Shape: 9 cases were showed multiple focal features, another one showed diffuse changes; (5)Pathological Fracture: 3 cases associated with pathological fractures of vertebrae. Conclusion The sensitivity of MRI was excellent for detecting marrow infiltration of lymphoma, but the specificity was poor.