Lecouvet F E, Vande Berg B C, Maldague B E, Michaux L, Laterre E, Michaux J L, Ferrant A, Malghem J
Department of Medical Imaging, St Luc University Hospital, University of Louvain, Brussels, Belgium.
Radiology. 1997 Jul;204(1):195-9. doi: 10.1148/radiology.204.1.9205246.
To study the appearance and distribution of vertebral compression fractures on magnetic resonance (MR) images in patients with multiple myeloma.
Two hundred twenty-four vertebral compression fractures were studied on 216 sagittal T1-weighted spin-echo and T2*-weighted gradient-echo MR images of the thoracolumbar spine obtained before and during treatment in 37 patients with multiple myeloma. Vertebral compression fractures observed at diagnosis and during follow-up were determined as being benign- or malignant-appearing at MR imaging according to literature criteria, and their distribution along the spine was recorded.
One hundred forty-nine (67%) of the 224 vertebral compression fractures appeared benign; 75 (33%) appeared malignant. Of the 37 patients, 14 (38%) had only benign-appearing vertebral compression fractures at diagnosis. One hundred five fractures (87%) were observed between T-6 and L-4, and 112 (50%) occurred between T-11 and L-3. Eight (4%) vertebral compression fractures involved the upper three thoracic vertebrae.
Most vertebral compression fractures in patients with multiple myeloma appear benign at MR imaging, and their distribution is similar to that observed in osteoporotic fractures. The possibility of multiple myeloma should not be excluded in patients with benign-appearing vertebral compression fractures at MR imaging.
研究多发性骨髓瘤患者脊柱压缩性骨折在磁共振（MR）图像上的表现及分布情况。
对37例多发性骨髓瘤患者治疗前及治疗期间获取的216幅胸腰椎矢状面T1加权自旋回波和T2*加权梯度回波MR图像上的224处椎体压缩性骨折进行研究。根据文献标准，将诊断时及随访期间观察到的椎体压缩性骨折在MR成像上判定为良性或恶性表现，并记录其在脊柱上的分布情况。
224处椎体压缩性骨折中，149处（67%）表现为良性；75处（33%）表现为恶性。37例患者中，14例（38%）在诊断时仅有良性表现的椎体压缩性骨折。105处骨折（87%）位于T-6至L-4之间，112处（50%）发生在T-11至L-3之间。8处（4%）椎体压缩性骨折累及上三个胸椎。
多发性骨髓瘤患者的大多数椎体压缩性骨折在MR成像上表现为良性，其分布与骨质疏松性骨折相似。对于MR成像上表现为良性的椎体压缩性骨折患者，不应排除多发性骨髓瘤的可能性。
