脊柱多发性骨髓瘤的MRI表现

目的：探讨脊柱多发性骨髓瘤的ＭＲＩ表现。方法：对２０例经骨髓穿刺证实的多发性骨髓瘤进行了下位胸椎和腰椎的常规Ｘ线和ＭＲＩ检查。根据ＭＲＩ信号异常的形态特点分为３型：局灶型、混杂型和弥漫型。结果：１２例ＭＲＩ信号异常，其中局灶型７例、混杂型２例和弥漫型３例。９例表现为Ｔ１ＷＩ低信号和Ｔ２ＷＩ高信号，且均未经治疗。５例的血红蛋白（１００ｇ／Ｌ和血清钙）２．５ｍｍｏｌ／Ｌ，均未经治疗，其中局灶型３例和混杂型２例。７例椎体压缩性骨折，其中仅２例是局灶型。结论：多发性骨髓瘤的脊柱ＭＲＩ检查有助于对其骨髓侵犯的检出。分型可能有助于对椎体压缩性骨折和贫血、高钙血症的认识。ＭＲＩ信号特点可以与是否经治疗有关。

MRI Features of Multiple Myeloma in the Vertebral Column

Objective:To evaluate the MRI features of multiple myeloma in the vertebral column.Methods:20 patients with multiple myeloma of the lower thoracic and lumbar spine were proved by patology,MRI manifestations could be divided into 3 patterns depending on the marrow involvement:focal,variegated and diffuse.Results:12 patients had abnormal MRI appearances,whose patterns were 7 cased focal,2 cases variegated and 3 cases diffuse,9 patients presented as hypointensity on T 1WI and hyperintensity on T 2WI,all of them were with untreated.5 patients (3 focal and 2 variegated)were noted with hemoglobin level<100g/L and serum calcium level>2.5 mmol/L,all of them were also with untreated.In 7 patients showed compression fracture of vertebral bodies,only 2 cases revealed focal lesions.Conclusion:MRI is helpful in detecting the bone marrow involvement of the multiple myeloma,the MRI patterns may be useful in making comprehensive recognization of the spinal compression fracture,anemia and high serum calcium level,the MR signal features may be relative to the treatment or not.