脊柱骨髓瘤的影像学诊断

目的 探讨脊柱骨髓瘤的影像学诊断价值及该病诊断与鉴别诊断要点.方法 回顾分析15例脊柱骨髓瘤患者的临床及X线、CT与MRI检查资料.结果 X线平片无阳性发现者5例,骨质疏松不伴骨质破坏者4例,骨质疏松伴骨质破坏者6例.11例CT检查4例表现为骨质疏松不伴骨质破坏,7例表现为骨质疏松伴溶骨性或穿凿样骨质破坏.14例MRI检查1例表现为骨质疏松,13例显示椎体单发或多发骨质破坏所致异常信号,分别呈局灶型、弥漫型和不均匀型.结论 X线平片对脊柱骨髓瘤的诊断敏感性较低,CT和MRI易于显示椎体骨质破坏,尤以MRI显示效果最佳,是目前诊断该病的最佳影像学检查法.诊断时需与脊柱转移瘤、脊柱结核及单纯脊柱骨质疏松等相鉴别.

Imaging Diagnosis of Myeloma of Spine

Objective To investigate the imaging diagnostic value and the important points of imaging diagnosis and differentiate diagnosis of myeloma of the spine. Methods The clinical and imaging data of 15 cases with myeloma of the spine were retrospectively reviewed. Results Of 15 cases with X - ray examinations, no abnormality was found in 5 cases, vertebral bone rarefaction without bone destruction in 4 cases, vertebral bone rarefaction with bone destruction in 6 cases. Of 11 cases with CT examinations, vertebral bone rarefaction without bone destruction were showed in 4 cases, vertebral bone rarefaction with osteolysis or hole bone destruction in 7 cases. Of 14 cases with MRI examinations, vertebral bone rarefaction without bone destructionl cases was found in 1 case, solitary or multiple vertebral bone destruction lesions were showed in the other 13 cases, and the lesions of bone destruction could be classified into three types based on MRI findings, e. g. localized, diffused and non - uniform. Conclusion X - ray examination has lower diagnostic sensitivity to myeloma of the spine. Both CT and MRI are all very sensitive to show the bone destruction of myeloma, and especially MRI is superior to CT in diagnosis of this disease. This disease should be differentiated with other diseases such as metastatic tumor of spine, tuberculosis of spine and simple vertebral bone rarefaction.