Lecouvet F E, Malghem J, Michaux L, Michaux J L, Lehmann F, Maldague B E, Jamart J, Ferrant A, Vande Berg B C
Department of Medical Imaging, St Luc University Hospital, University of Louvain, Brussels, Belgium.
Radiology. 1997 Jul;204(1):201-5. doi: 10.1148/radiology.204.1.9205247.
To determine the utility of bone marrow magnetic resonance (MR) imaging in the assessment of risk of vertebral compression fractures in patients with multiple myeloma.
In 50 patients with stage III multiple myeloma, 280 MR examinations of the thoracolumbar spine obtained at diagnosis and during treatment (mean follow-up, 28 months) were analyzed to determine MR patterns of bone marrow involvement before treatment and the occurrence of vertebral compression fracture at follow-up. Four MR patterns of marrow involvement were determined: A, normal marrow appearance; B, fewer than 10 focal lesions; C, more than 10 focal lesions; and D, diffuse infiltration. Fracture-free survival was compared according to these patterns.
During follow-up, 131 vertebral compression fractures appeared in 37 patients. Patients with pattern A (n = 10) or B (n = 16) had significantly longer fracture-free survival before occurrence of the first, second, and third fractures than those with pattern C or D (P < 10(-5)). Relative risks of first, second, and third fracture occurrence for patients with pattern C or D compared with those with pattern A or B were 6.2, 9.1, and 11.0, respectively.
Determination of MR patterns of spinal bone marrow involvement is a potential relevant factor to predict the risk of vertebral fractures in patients with stage III multiple myeloma.
确定骨髓磁共振成像（MR）在评估多发性骨髓瘤患者椎体压缩骨折风险中的作用。
对50例III期多发性骨髓瘤患者在诊断时及治疗期间（平均随访28个月）获得的280次胸腰椎MR检查进行分析，以确定治疗前骨髓受累的MR表现形式以及随访时椎体压缩骨折的发生情况。确定了骨髓受累的四种MR表现形式：A，骨髓外观正常；B，少于10个局灶性病变；C，多于10个局灶性病变；D，弥漫性浸润。根据这些表现形式比较无骨折生存期。
随访期间，37例患者出现了131次椎体压缩骨折。A组（n = 10）或B组（n = 16）患者在首次、第二次和第三次骨折发生前的无骨折生存期明显长于C组或D组患者（P < 10(-5)）。与A组或B组患者相比，C组或D组患者首次、第二次和第三次骨折发生的相对风险分别为6.2、9.1和11.0。
确定脊柱骨髓受累的MR表现形式是预测III期多发性骨髓瘤患者椎体骨折风险的一个潜在相关因素。
