多发性骨髓瘤伴蝶鞍斜坡区浆细胞瘤CT及MRI表现(附3例报告及文献复习

CT and MRI features of multiple myeloma associated with plasmacytoma located in the spheno-clival region:three cases and literature review

目的:探讨多发性骨髓瘤伴蝶鞍斜坡区浆细胞瘤浸润的临床特点及影像诊断要点。方法:收集我院收治的3例蝶鞍斜坡区浆细胞瘤,最终临床确诊为多发性骨髓瘤患者的临床及影像学资料,3例患者均行CT及MRI扫描。结果:3例患者CT上均可见蝶鞍斜坡区密度均匀的实性肿块,伴溶骨性破坏。MRI上肿瘤边界清晰,其中2例T1WI表现为均匀等信号,1例呈混杂稍高信号;T2WI上1例呈等信号,2例呈稍高信号;2例术前行增强扫描肿块示明显均匀强化,2例行弥散加权成像呈稍高信号。结论:多发性骨髓瘤伴蝶鞍斜坡区浆细胞瘤较罕见,若仅以神经系统症状就诊,需与好发于该部位的其他肿瘤相鉴别,但其MRI表现具有一定特征性,结合临床表现及实验室检查有助于提高对该疾病的正确诊断能力,确诊需依靠病理活检。

Objective： To explore the clinical and imaging characteristics of plasmacytoma located in the spheno-elival region with muhiple myeloma. Methods： The clinical materials and imaging information of three cases clinically confirmed sphenn-clival plasmaeytoma with multiple myeloma were reported. All of them perfnrmed CT and MRI scanning in our hospi- tal. Results： In all of the three cases, homogeneous iso-density mass grew in the spheno-elival region with lytic hone de- struction was shown nn CT image. All masses were shown clear margin on MRI, two cases were homogeneous iso-intensity on T1WI, and one case was heterogeneous slightly hyper-intensity. One case demonstrated iso-intensity on T2WI, and the other two were shown slightly hyper-intensity. Twu cases were performed contrated enhance MRI scanning before operation, aud hoth of them demonstrated obvious homogeneous enhancement. DWI was performed on two cases and showed slightly hyper-intensi- ty. Conclusion： Plasmacytoma located in the spheno-elival region with multiple myeloma is rare. If patients only show up with neurological symptoms, it needs to differential with other tumors frequently occur in this area. To combine analysing ils characteristic appearance of MRI with clinical features and laboratury examinations ways would be helpful to improve the di- agnostic accuracy, and final diagnosis need to be confirmed by pathological biopsy.