Fruehwald F X, Tscholakoff D, Schwaighofer B, Wicke L, Neuhold A, Ludwig H, Hajek P C
Department of Internal Medicine II, University of Vienna, Austria.
Invest Radiol. 1988 Mar;23(3):193-9. doi: 10.1097/00004424-198803000-00007.
Eighteen patients with multiple myeloma (clinical stages 1-3) and a control group of 21 persons underwent magnetic resonance imaging (MRI) studies of the lower thoracic and lumbar spine. This was done to determine the potential benefit of MRI in addition to conventional radiographs, tomograms, computed tomography and nuclear scans. In addition to focal fatty replacement of normal hematopoietic marrow, which presented as focal hyperintense lesions on T1-weighted images (T1-WI) and on T2-weighted images (T2-WI), two types of myelomatous lesions were found: (1) focal areas with reduced signal intensity when compared with normal bone marrow on T1-WI and enhanced signal intensity on T2-WI, mainly found in untreated myelomas; and (2) focal areas of decreased signal intensity on T1-WI and on T2-WI, which were predominantly detected after previous radiation therapy. MRI surpassed conventional radiography in detecting abnormal focal marrow infiltration in 41 of 247 vertebrae. Radiographs identified only 11 of the 41 as pathologic, based on shape and structure of the vertebral bodies; however, 15 other collapsed vertebrae showed no signal abnormalities of the marrow on MR images. Discrimination of normals and abnormals by statistical analysis of intensity measurements of the bone marrow was not possible.
18例多发性骨髓瘤患者（临床分期1 - 3期）和21名对照组人员接受了胸腰椎下部的磁共振成像（MRI）检查。这样做是为了确定除传统X线片、断层扫描、计算机断层扫描和核扫描外，MRI的潜在益处。除了正常造血骨髓的局灶性脂肪替代，其在T1加权像（T1-WI）和T2加权像（T2-WI）上表现为局灶性高信号病变外，还发现了两种类型的骨髓瘤病变：（1）与正常骨髓相比，在T1-WI上信号强度降低而在T2-WI上信号强度增强的局灶区域，主要见于未经治疗的骨髓瘤；（2）在T1-WI和T2-WI上信号强度均降低的局灶区域，主要在先前放疗后检测到。在检测247个椎体中的异常局灶性骨髓浸润方面，MRI优于传统X线检查。基于椎体的形状和结构，X线片仅将41个中的11个识别为病理性的；然而，另外15个塌陷椎体在MR图像上骨髓未显示信号异常。通过对骨髓强度测量进行统计分析来区分正常和异常是不可能的。
