初诊为多发髓外病变的多发性骨髓瘤的CT及MRI诊断

The CT and MRI imaging diagnosis of newly-diagnosed multiple extramedullary disease of multiple myeloma

目的探讨初诊以多发髓外病变(EMD)为主要表现的多发性骨髓瘤(MM)的CT及MRI影像学表现,提高临床对该病的影像学认识。方法选取我院15例初诊经组织病理学证实为多发髓外浆细胞瘤,后经骨髓穿刺病理学证实为MM的34个软组织肿块的影像学资料。结果初诊时以多发EMD的MM特征性的影像学表现如下:1)多发软组织肿块影,其中受累骨质旁巨大软组织肿块是最常见病变部位;2)软组织肿块密度或信号较均匀,CT呈等密度,MRI T2WI呈等或稍高信号,T1WI呈等或稍低信号;3)增强扫描呈中等-明显强化;4)病变较大时肿块内部或周边可见迂曲走行的血管影;5)可缺乏MM特征性影像学表现。结论以多发EMD初诊的MM具有一定影像学特点,CT和MRI检查能够对其诊断、治疗及随访提供更全面的信息。

Objective To study the CT and MRI image features of newly-diagnosed multiple extramedullary disease(EMD)of multiple myeloma(MM).Methods The CT and MRI image findings of 34 soft tissue masses of 15 MM cases,which were verified by histopathology at the initial diagnosis of multiple extramedullary plasmacytoma,were analyzed retrospectively.Results The image features of newly-diagnosed MM with multiple EMD were as followed 1)Destruction of bone and multiple extramedullary disease parosteal soft tissue mass were the most common lesion;2)Multiple soft tissue mass presented with homogeneous density or signal,which demonstrated isodensity on CT,iso-hypo intensity on T1WI and iso-hyper intensity on T2WI;3)The enhancement of soft tissue mass was moderate-strong homogenous;4)A lot of vessels could be found on the circumference or inside the large lesion;5)They may lack of the characteristic imaging of MM.Conclusion There are some characteristic imaging features of newly-diagnosed MM with EMD on CT and MRI,which can give more information on diagnosis,therapy and follow-up information.