多发性骨髓瘤的X线、CT、MRI和~(18)F-FDGPET/CT诊断价值

目的探讨多发性骨髓瘤在X线、CT、MRI及18F-FDG PET/CT上的表现,提高对多发性骨髓瘤在影像学上的认识。方法对经病理及临床确诊的110例多发性骨髓瘤患者的影像学资料进行回顾性分析。结果 110例中X线94例,发现异常62例,诊断符合率65.9%;CT90例,发现异常82例,诊断符合率91.1%;MRI36例,发现异常34例,诊断符合率94.4%;18F-FDG PET/CT15例,发现异常14例,诊断符合率93.3%。4种检查方法对多发性骨髓瘤诊断符合率之间差异有统计学意义(χ2=26.18,P0.05),X线诊断符合率低于另外三种检查,差异有统计学意义(χ2=25.98,P0.05);CT、MRI及18FFDG PET/CT三种检查结果无统计学差异(χ2=0.43,P0.05)。多发性骨髓瘤X线及CT主要表现是骨质稀疏、膨胀及破坏,伴有病理性骨折及软组织肿块,少数有骨质硬化;MRI表现为T1WI低信号,T2WI为高信号,典型变现为"盐-椒征";18FFDG PET/CT表现为相匹配的18F-FDG高摄取灶及骨质溶骨性改变。结论多发性骨髓瘤的影像学表现具有特征性,四种检查方法各有优势,认识及了解其影像学表现,对诊断多发性骨髓瘤具有重要作用。

Multiple Myeloma X-ray,CT, MRI and18F- FDG PET/CT Diagnosis Value

Objective To explore multiple myeloma in X-ray, CT , MRI and18F-FDG PET/CT performance, improve the understanding of multiple myeloma in imaging. Methods 55 cases confirmed by pathology and clinical patients with multiple myeloma imaging data were retrospectively analyzed.Results X-ray of 94 cases in 110 cases with abnormal 62 cases, the diagnosis coincidence rate 65.9%, CT 90 cases, 82 abnormal cases, the diagnosis coincidence rate 91.1%. MRI36 example, there are 34 cases, abnormal diagnosis coincidence rate 94.4%,18F-FDG PET/CT15 cases, 14 cases have abnormal, diagnostic coincidence rate was 93.3%. Four inspection methods for multiple myeloma diagnosis coincidence rate between the difference was statistically significant (χ2=26.18, P<0.05), and X-ray diagnosis coincidence rate is lower than the other three kinds of inspection, the difference was statistically significant (χ2=25.98, P<0.05), CT, MRI and18F-FDG PET/CT three test results no statistical differences (χ2=0.43, P>0.05). Multiple myeloma X-ray and CT main show is sparse, bone expansion and destruction, with pathological fracture and soft tissue mass, a few bone sclerosis; MRI of T1WI low signal, for high T2WI signal, a typical cash as the "salt and pepper".18F-FDG PET/CT performance for matching the high18F-FDG uptake stove and bone dissolve osseous changes.Conclusion Multiple myeloma has characteristic imaging findings, three inspection methods have their own advantages, to know and understand its imaging findings, plays an important role in diagnosis of multiple myeloma.