多发性骨髓瘤的影像诊断

目的提高对多发性骨髓瘤的影像诊断水平。方法分析骨穿和(或)病检证实的42例多发性骨髓瘤x线片、cT及MRI的影像诊断学特点。结果42例均经X线检查，35例(76％)发现形形色色的溶骨性破坏，主要在头颅(27例)、胸椎(26例)、腰椎(30例)、肋骨(15例)及骨盆(11例)，30例伴发骨质疏松。CT检查17例不仅检出X线片所示的骨破坏，有6例检出X线未能明确的肋骨、骨盆、椎体附件破坏和软组织肿块。脊椎MRI检查18例，正常型1例，灶型5例，弥漫型5例，弥漫型 灶型5例，椒盐型2例(阳性率94％)。结论多发性骨髓瘤有一定的利于诊断的影像特点，MRI特别对脊椎病变优于X线平片和CT检查，并有助于早期诊断。

Imaging diagnosis of multiple myeloma

Objective To elevate the recognition of multiple myeloma (MM) and its diagnostic level.Methods Imaging findings of 42 patients with clinically or pathologically proved MM were analyzed retrospectively.Results 35 of 42 patients who underwent X-ray examinations presented bony destruction in varied degrees and patterns,of them,skull bone was found in 27.thoracic vertebra in 26,lumbal vertebra in 30,rib in 15,pelves in 11 and complicated osteoporosis in 30.Among 17 patients who underwent CT examinations,CT not only showed the bony destructions which were visible on X-ray films also revealed some other lesions which were invisible on X-ray films such as destructive lesions of rib,pelves vertebral, appendage and soft tissue mass in 6 cases.Among 18 patients who underwent MRI of spine,non-abnormality was found in 1,focal lesions in 5,diffuse plus local lesions in 5,and pepper-salt pattern in 2(positive ratio 94 %).Conclusion Multiple myeloma has some imaging features with diagnostic significance, especially MRI is superior to both CT and radiography in the diagnosis of spine lesions and early diagnosis of MM.