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[POEMS综合征:骨骼表现的影像学研究,8例病例分析]

[POEMS syndrome: imaging of skeletal manifestations, a study of 8 cases].

作者信息

Michel J L, Gaucher-Hugel A S, Reynier C, Lhoste A, Philippe P, Aumaitre O, Piette J C, Soubrier M

机构信息

Service de Radiologie GM St-Jacques, Paris.

出版信息

J Radiol. 2003 Apr;84(4 Pt 1):393-7.

Abstract

PURPOSE

To describe the imaging features of POEMS, and to compare our experience of 8 cases to a review of literature.

MATERIALS AND METHODS

This retrospective study included 8 patients (6 men, 2 women) with POEMS. Plain radiographs (8 patients), CT (6), MR (2) were performed.

RESULTS

Topographic localizations of POEMS were pelvis (7 cases), spine (5), femur (1), humerus (1), rib cage (1). Focal bone lesions, multiple (5 cases) or solitary (3 cases), were sclerotic in 4 cases, mixed lytic-sclerotic (lytic center and sclerotic rim) in 3 cases and one patient had an osteolytic lesion with sclerotic margins associated with many osteosclerotic lesions. Profilerative osseous changes were seen in 4 cases (pelvis, spine, tibia). MR imaging was performed in 2 patients: in one patient MR imaging revealed areas of low signal intensity on spin echo T1- and T2-weighted images in vertebral bodies, the other showed a lesion of low signal intensity on spin echo T1-weighted and high signal intensity on T2-weighted images in the ilium and adjacent soft tissue.

CONCLUSION

The imaging features commonly observed in POEMS syndrome are sclerotic and mixed lytic-sclerotic lesions, particularly in the pelvis and spine. Proliferative new bone formation is detected in 50%. MR imaging correlates with ostesclerotic or mixed lytic-sclerotic appearance.

摘要

目的

描述POEMS综合征的影像学特征,并将我们8例患者的经验与文献回顾进行比较。

材料与方法

这项回顾性研究纳入了8例POEMS综合征患者(6例男性,2例女性)。进行了X线平片检查(8例患者)、CT检查(6例)、MR检查(2例)。

结果

POEMS综合征的病变部位为骨盆(7例)、脊柱(5例)、股骨(1例)、肱骨(1例)、胸廓(1例)。局灶性骨病变,多发(5例)或单发(3例),4例为硬化性,3例为溶骨-硬化混合性(溶骨中心和硬化边缘),1例患者有1个边缘硬化的溶骨性病变并伴有许多骨硬化性病变。4例患者(骨盆、脊柱、胫骨)可见骨质增生改变。2例患者进行了MR成像:1例患者的MR成像显示椎体在自旋回波T1加权和T2加权图像上呈低信号区,另1例患者的MR成像显示髂骨及邻近软组织在自旋回波T1加权图像上呈低信号病变,在T2加权图像上呈高信号。

结论

POEMS综合征常见的影像学特征为硬化性和溶骨-硬化混合性病变,尤其是在骨盆和脊柱。50%的患者可检测到新生骨形成。MR成像与骨硬化或溶骨-硬化混合表现相关。

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