Lecouvet F E, Vande Berg B C, Michaux L, Malghem J, Maldague B E, Jamart J, Ferrant A, Michaux J L
Department of Radiology and Medical Imaging, Saint Luc University Hospital, Brussels, Belgium.
Radiology. 1998 Dec;209(3):653-60. doi: 10.1148/radiology.209.3.9844655.
To determine the clinical and prognostic value of spinal bone marrow magnetic resonance (MR) imaging in stage III multiple myeloma.
In 80 patients with untreated, newly diagnosed stage III multiple myeloma, initial MR imaging patterns of spinal bone marrow involvement were correlated with hematologic parameters and response to induction chemotherapy. The influence of these patterns on survival was studied in 57 patients who did not undergo cytotoxic therapy with stem cell transplantation.
MR imaging patterns of marrow involvement were normal in 19 (24%) patients, focal in 35 (44%), and diffuse in 26 (32%). Patients with the diffuse pattern had higher marrow plasmacytosis (P < or = .003) and cellularity (P < or = .001), higher serum calcium (P < or = .005) and beta 2-microglobulin (P < or = .008) levels, and lower hemoglobin values (P < or = .001) than did those with the normal or focal patterns. Patients with the normal pattern responded better to therapy (P = .007) and survived longer than patients with an abnormal pattern (P = .026). MR imaging findings and C-reactive protein level were the best independent prognostic indicators of survival.
MR imaging patterns of spinal bone marrow involvement are correlated with several clinical parameters of disease severity and have prognostic value in stage III multiple myeloma.
确定脊柱骨髓磁共振成像（MR）在III期多发性骨髓瘤中的临床及预后价值。
对80例未经治疗、新诊断的III期多发性骨髓瘤患者，将脊柱骨髓受累的初始MR成像模式与血液学参数及诱导化疗反应进行关联分析。在57例未接受干细胞移植细胞毒性治疗的患者中，研究这些模式对生存的影响。
19例（24%）患者骨髓受累的MR成像模式正常，35例（44%）为局灶性，26例（32%）为弥漫性。与正常或局灶性模式患者相比，弥漫性模式患者的骨髓浆细胞增多（P≤0.003）、细胞增多（P≤0.001），血清钙（P≤0.005）和β2微球蛋白水平（P≤0.008）更高，血红蛋白值更低（P≤0.001）。正常模式患者对治疗反应更好（P = 0.007），生存期比异常模式患者更长（P = 0.026）。MR成像结果和C反应蛋白水平是生存的最佳独立预后指标。
脊柱骨髓受累的MR成像模式与疾病严重程度的多个临床参数相关，在III期多发性骨髓瘤中具有预后价值。
