Moulopoulos L A, Dimopoulos M A, Alexanian R, Leeds N E, Libshitz H I
Department of Diagnostic Radiology, University of Texas M.D. Anderson Cancer Center, Houston.
Radiology. 1994 Nov;193(2):441-6. doi: 10.1148/radiology.193.2.7972760.
To assess changes in the magnetic resonance (MR) appearance of the spine in patients with multiple myeloma who responded to chemotherapy.
Twenty patients with multiple myeloma underwent MR imaging of the spine before and after chemotherapy. Sagittal T1-weighted images were obtained before and after administration of contrast material. MR patterns of marrow involvement before treatment were classified as focal, diffuse, or variegated. The changes seen on MR images after treatment were analyzed and correlated with the clinical response as defined with standard criteria.
Patterns of complete response included resolution of marrow abnormality or persistent abnormality without enhancement or with peripheral rim enhancement. Conversion of a diffuse to a variegated or focal pattern and a decrease in the amount of marrow abnormality with persistent enhancement were observed in patients who showed a partial response. Ten patients sustained new or progressive compression fractures after successful therapy.
Recognition of spinal MR patterns of response to treatment supported the occurrence of remission in patients with multiple myeloma. MR findings may help clarify response to therapy in patients with equivocal clinical changes or nonsecretory myeloma.
评估多发性骨髓瘤患者化疗有效时脊柱的磁共振（MR）表现变化。
20例多发性骨髓瘤患者在化疗前后接受了脊柱MR成像。在注射对比剂前后获取矢状面T1加权图像。治疗前骨髓受累的MR模式分为局灶性、弥漫性或斑驳状。分析治疗后MR图像上的变化，并与标准标准定义的临床反应相关联。
完全缓解模式包括骨髓异常消失或持续存在异常但无强化或周边强化。部分缓解的患者观察到弥漫性模式转变为斑驳状或局灶性模式，且骨髓异常量减少并持续强化。10例患者在成功治疗后出现新的或进行性压缩性骨折。
识别脊柱MR治疗反应模式有助于支持多发性骨髓瘤患者缓解的发生。MR表现可能有助于明确临床变化不明确或非分泌性骨髓瘤患者的治疗反应。
