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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,P<0.05),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,P<0.05);CT、MRI及18FFDG PET/CT三种检查结果无统计学差异(χ2=0.43,P>0.05)。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。
Objective To investigate the manifestations of multiple myeloma on X-ray, CT, MRI and 18F-FDG PET / CT and to improve the imaging knowledge of multiple myeloma. Methods The imaging data of 110 patients with multiple myeloma confirmed by pathology and clinic were retrospectively analyzed. Results Of the 110 cases, X-ray was found in 94 cases, 62 cases were found abnormal and the diagnostic coincidence rate was 65.9%. CT90 cases showed abnormalities in 82 cases, the diagnostic coincidence rate was 91.1%. MRI 36 cases found abnormalities in 34 cases, the diagnostic coincidence rate was 94.4% FDG PET / CT15 cases, found abnormal in 14 cases, the diagnostic accuracy rate of 93.3%. There was significant difference between the four methods in the diagnosis of multiple myeloma (χ2 = 26.18, P <0.05). The coincidence rate of X-ray diagnosis was lower than the other three tests (χ2 = 25.98 , P <0.05). The results of CT, MRI and 18 FFDG PET / CT showed no significant difference (χ2 = 0.43, P> 0.05). The main manifestations of X-ray and CT in multiple myeloma are osteoporosis, swelling and destruction, accompanied by pathological fracture and soft tissue mass, a small number of osteopetrosis; MRI showed low signal of T1WI, high signal of T2WI, “Salt - pepper levy”; 18FFDG PET / CT showed a matched 18F-FDG high uptake stove and bone osteolytic changes. Conclusion The imaging findings of multiple myeloma are characteristic. The four examination methods have their own advantages. Understanding and understanding the imaging findings of multiple myeloma has an important role in the diagnosis of multiple myeloma.