脊柱孤立性浆细胞瘤的临床及影像学特征分析

Clinical and Imaging Features of Solitary Plasmacytoma of Spine

目的分析脊柱孤立性浆细胞瘤(SPS)的临床及影像学特征。方法回顾性分析经手术病理证实的15例脊柱孤立性浆细胞瘤临床及影像学资料,总结脊柱孤立性浆细胞瘤临床及影像学特点。结果SPS首发表现主要为病椎及周围疼痛,疼痛随着病情加重逐渐加重,常伴神经或脊髓症状及特征。15例SPS患者X线片均表现出椎体骨质破坏特点。12例CT扫描表现:溶骨性骨质破坏;边界模糊不清,残存骨皮质及骨小梁结构6例;椎体内高、低密度影混杂6例。MRI扫描表现:T1WI序列均为低信号,T2WI序列多为略高或高信号;累及附件6例;脊髓或硬膜均受压;横断位存在"微脑样"特征;增强扫描均表现出不同程度均匀强化。结论 CT、MRI可对SPS病灶范围及形态特征有效反映,CT在瘤体内残存骨质或骨小梁显示上有明显优势,MRI典型特征为"微脑样"骨质破坏。需根据患者临床表现、多种影像学检查(以CT、MRI为主)辅助确诊。

Objective To analyze the clinical and imaging features of solitary plasmacytoma of spine（SPS）. Methods The clinical and imaging data of 15 cases of SPS confirmed by surgery and pathology were retrospectively analyzed. The clinical and imaging features of SPS were summarized. Results The first-episode manifestations of SPS were pain of the diseased spine and peripheral pain and the pain gradually increased with the aggravation of the disease, often complicated by the symptoms and characteristics of nerve or spinal cord. The X-ray images of 15 cases of SPS patients showed features of destruction of vertebral bodies. The CT scan showed that there were 12 cases of osteolytic bone destruction, 6 cases with unclear boundaries, remaining bone cortex and trabecular bone structure and 6 cases with mixed high and low-density shadow. MRI scan showed that T1 WI sequence was low signal and the T2 WI sequence was slightly higher or high signal. There were 6 cases of involved adnexa. The spinal cord or dura mater were compressed. There existed microbrain-like features in the cross section. The enhanced scan showed even enhancement to varying degrees. Conclusion CT and MRI can effectively reflect the range and shape of SPS lesions, and CT has obvious advantages in the reflection of remaining bone cortex and trabecular bone in tumors. The typical characteristic of MRI is microbrain-like bone destruction. A variety of imaging examinations（ mainly were CT and MRI） should be dopted to assist diagnosis according to the clinical manifestations of patients.