DETECTION OF MULTIPLE-MYELOMA INVOLVING THE SPINE - EFFICACY OF FAT-SUPPRESSION AND CONTRAST-ENHANCED MR IMAGING
DETECTION OF MULTIPLE-MYELOMA INVOLVING THE SPINE - EFFICACY OF FAT-SUPPRESSION AND CONTRAST-ENHANCED MR IMAGING
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DOI：
10.2214/ajr.160.5.8470574
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发表时间：
1993-05-01
影响因子：
5
通讯作者：
VASILE, N
中科院分区：
文献类型：
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作者：
RAHMOUNI, A;DIVINE, M;VASILE, N
OBJECTIVE.为了确定脂肪抑制序列和对比增强MR成像检测多发性骨髓瘤引起的局灶性脊柱病变的有效性，我们获得了32例新诊断的骨髓瘤患者的MRI图像，这些患者有背痛。所有患者均经活检证实为骨髓瘤，并在脊柱疼痛节段进行了MR成像。获得自旋回波T1加权、T2加权和短TI反转恢复（STIR）图像;静脉注射一团顺磁性造影剂后的动态超快低角度拍摄（turbo-FLASH）图像;以及对比增强T1加权图像。我们定性比较了病灶与周围椎体的信号强度和增强情况。32例患者中除2例外均检测到多发性病变。在T2加权像和STIR像上，所有病灶均呈均匀高信号。在T1加权像上，除了4例患者的病灶呈等信号或高信号外，所有患者的病灶与周围骨骼相比均呈低信号。所有肿瘤结节在动脉期获得的turbo-FLASH图像上均增强。STIR或对比增强图像上未观察到其他病变。MR结果导致1例患者的疾病分期发生变化，并导致5例硬膜外受累患者的及时治疗。磁共振成像似乎有助于检测多发性骨髓瘤患者的脊柱受累。脊柱病变的诊断最好采用脂肪抑制或T2加权成像。尽管所有患者的骨髓瘤病灶均增强，但造影剂似乎对检测其他病灶没有价值。
OBJECTIVE. To determine the efficacy of fat-suppressed sequences and contrast-enhanced MR imaging for the detection of focal spinal lesions caused by multiple myeloma, we obtained MR images in 32 patients with newly diagnosed myeloma who had back pain.SUBJECTS AND METHODS. All patients had biopsy-proved myeloma and had MR imaging at the painful level of the spine. Spin-echo T1-weighted, T2-weighted, and short TI inversion-recovery (STIR) images; dynamic ultrafast low-angle shot (turbo-FLASH) images after IV injection of a bolus of paramagnetic contrast material; and contrast-enhanced T1-weighted images were obtained. We qualitatively compared the signal intensities and contrast enhancement of focal lesions with those of the surrounding vertebral bodies.RESULTS. Multiple lesions were detected in all but two of the 32 patients. On T2-weighted and STIR images, all lesions had homogeneously high signal intensity. On T1-weighted images, the lesions were visible as hypointense areas compared with surrounding bone in all except four patients, in whom the lesions were isointense or hyperintense. All tumor nodules enhanced on turbo-FLASH images obtained in the arterial phase. No additional lesions were seen on STIR or contrast-enhanced images. MR findings resulted in a change in the staging of the disease in one patient and led to prompt treatment in five patients with epidural involvement.CONCLUSION. MR imaging appears to be helpful in detecting spinal involvement in patients with multiple myeloma. The diagnosis of spinal lesions is best achieved by using either fat-suppressed or T2-weighted images. Although myeloma lesions enhanced in all patients, contrast material appears to be of no value for the detection of additional lesions.