脊柱孤立性浆细胞瘤的MR表现

目的：总结脊柱孤立性浆细胞瘤的ＭＲ表现，提高对该病的认识。方法：搜集了４ 例经我院病理证实的脊柱孤立性浆细胞瘤，全部病人均在我院行ＭＲ检查。结果：４例脊柱孤立性浆细胞瘤中，均只累及单个椎体，３ 例位于胸椎，１例位于颈椎。肿瘤以累及一侧椎体附件为主，１ 例肿瘤引起椎体压缩骨折。肿瘤多表现为较均匀的等或稍高Ｔ１ 信号，高Ｔ２ 信号，注药后均匀强化。肿瘤边界清楚。均可见骨质破坏，但无骨硬化及增生。在本组２例行本周蛋白检查病人，全部表现阴性。结论：浆细胞瘤的ＭＲ表现与肿瘤起源部位和浸润范围有着密切关系。ＭＲ检查很难确诊脊柱浆细胞瘤，但相应的ＭＲ表现能够提示该病及其鉴别诊断。ＭＲ能够清楚地显示肿瘤及其与周围组织的关系，是显示浆细胞瘤及其浸润范围的最佳影像学检查方法。

The MR Appearances of Solitary Spine Plasmacytomas

Objective:To define MR appearances of solitary spine plasmacytomas.Methods:Four patients with solitary spine plasmacytomas were examined with 1.5 T MR imaging system.The morphologic appearances and signal intensities of the lesions were analyzed with emphasis on tumor location,spinal canal involvement,bone invasion,and characteristics in contrast enhanced studies.Results:One cervical and 3 throtic solitary spine plasmacytomas were found as epidural masses.The tumor usually showed clear borders with relatively homogenous isohyperintensity on T 1WI and hyperintensity on T 2 WI.Two tumors with contrast studies demonstrated enhancement after contrast injection.All tumors displayed bone invasion and paraspinal masses.Laboratory studies in 2 patients showed negative Bence-Jones protein in urine.Conclusion:Solitary spine plasmacytoma exhibits various appearances and is difficult to differentiate from other common spinal tumors.However,MR is the best imaging tool in displaying the tumor and its relation with surrounding strutures.