Duvauferrier R, Valence M, Patrat-Delon S, Brillet E, Niederberger E, Marchand A, Rescan M, Guillin R, Decaux O
Radiology and Medical Imaging Department, Rennes University Hospitals, Hôpital Sud, BP 90347, 35203 Rennes cedex 2, France.
Internal Medicine Department, Rennes University Hospitals, Hôpital Sud, BP 90347, 35203 Rennes cedex 2, France.
Diagn Interv Imaging. 2013 Feb;94(2):169-83. doi: 10.1016/j.diii.2012.12.001. Epub 2013 Jan 5.
Radiology of bone lacunae can help differentiate between smouldering and symptomatic myeloma. CT seems to be more apt for this purpose than a standard X-ray but appropriate principles must be applied when performing and reading it. Lesions visible in an MRI above all allow myelomas to be monitored during treatment. Because of the radiation dose, whole body CT must be performed with a slice thickness of 2mm, increments of 1.5 and intensity of 40mAs. It should be read associating the reading of the axial slices with reading the mean coronal and sagittal projections of a thickness of 2cm. Whole body MRI must associate T1-weighted sagittal, STIR coronal and b-800 diffusion-weighted axial sequences. Changes in the disease correlate with changes in the diffusion, STIR and T1-weighted images interpreted together. While whole body CT has a place in clinical routine, the indication for whole body MRI still needs to be clarified and has yet to take its place in research protocols.
骨陷窝的放射学检查有助于鉴别冒烟型和有症状的骨髓瘤。对于此目的，CT似乎比标准X线更合适，但在进行和解读CT时必须应用适当的原则。MRI上可见的病变首先有助于在治疗期间监测骨髓瘤。由于辐射剂量的原因，全身CT必须以2mm的层厚、1.5的增量和40mAs的强度进行。解读时应将轴位图像的解读与厚度为2cm的平均冠状位和矢状位投影的解读相结合。全身MRI必须结合T1加权矢状位、短T1反转恢复序列（STIR）冠状位和b-800扩散加权轴位序列。疾病的变化与一起解读的扩散加权、STIR和T1加权图像的变化相关。虽然全身CT在临床常规中有一席之地，但全身MRI的适应证仍需明确，且尚未在研究方案中占据一席之地。
