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骨髓瘤的影像学检查,重点关注先进成像技术。

Imaging in myeloma with focus on advanced imaging techniques.

作者信息

Barwick Tara, Bretsztajn Laure, Wallitt Kathryn, Amiras Dimitri, Rockall Andrea, Messiou Christina

机构信息

1 Imperial College Healthcare NHS Trust , London , UK.

2 Department of Surgery and Cancer, Imperial College London , London , UK.

出版信息

Br J Radiol. 2019 Mar;92(1095):20180768. doi: 10.1259/bjr.20180768. Epub 2019 Jan 3.

Abstract

In recent years, there have been major advances in the imaging of myeloma with whole body MRI incorporating diffusion-weighted imaging, emerging as the most sensitive modality. Imaging is now a key component in the work-up of patients with a suspected diagnosis of myeloma. The International Myeloma Working Group now specifies that more than one focal lesion on MRI or lytic lesion on whole body low-dose CT or fludeoxyglucose (FDG) PET/CT fulfil the criteria for bone damage requiring therapy. The recent National Institute for Health and Care Excellence myeloma guidelines recommend imaging in all patients with suspected myeloma. In addition, there is emerging data supporting the use of functional imaging techniques (WB-DW MRI and FDG PET/CT) to predict outcome and evaluate response to therapy. This review summarises the imaging modalities used in myeloma, the latest guidelines relevant to imaging and future directions.

摘要

近年来,将扩散加权成像纳入其中的全身MRI在骨髓瘤成像方面取得了重大进展,已成为最敏感的检查方式。目前,成像检查是疑似骨髓瘤患者检查过程中的关键组成部分。国际骨髓瘤工作组现在明确规定,MRI上出现一个以上局灶性病变或全身低剂量CT或氟脱氧葡萄糖(FDG)PET/CT上出现溶骨性病变,即符合需要治疗的骨损伤标准。英国国家卫生与临床优化研究所最近发布的骨髓瘤指南建议,对所有疑似骨髓瘤患者进行成像检查。此外,越来越多的数据支持使用功能成像技术(全身扩散加权MRI和FDG PET/CT)来预测预后和评估治疗反应。本综述总结了骨髓瘤中使用的成像方式、与成像相关的最新指南以及未来的发展方向。

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