Layer G, Träber F, Block W, Bräucker G, Kretzer S, Flacke S, Schild H
Radiologische Klinik, Universität Bonn.
Rofo. 1998 Dec;169(6):596-600. doi: 10.1055/s-2007-1015347.
To evaluate the role of in vivo 1H MR spectroscopic determination of relaxation times and of fat and water content to differentiate between infiltration of multiple myeloma or osteoporosis in patients with roentgenologic unclear demineralization of the lumbar spine.
PATIENTS, MATERIALS AND METHODS: Ten patients each with osteoporotic reduction of bone mineral density (BMD), histologically proven multiple myeloma who showed only diffuse tumor manifestations without tumor compression fractures in the spine, and volunteers were investigated. Osteoporosis was confirmed by dual-energy X-ray absorptiometry (DXA) (Hologic QDR 2000 device, Siemens Medical Systems). The MR investigations were performed with a 1.5 T whole body system (Gyroscan S15/ACS II, Philips Medical Systems). Localized MR spectra from a cubic volume of about 8 cm3 were acquired by the PRESS technique. Chemical shift selective T1 relaxation times were obtained from an IR series, T2 was measured by variation of the interval between the first and the second echo in the volume selection scheme. Statistical analysis was done using the Kruskal-Wallis test and the Mann-Whitney test with the software SPSS.
There were highly significant differences in T2 values and fat content between patients with osteoporosis and multiple myeloma. T2 values were decreased in osteoporosis (37 ms and 59 ms vs. 44 ms and 70 ms in plasmocytoma) and fat content was decreased in multiple myeloma (20% vs 31% and 34% in volunteers and osteoporosis). Between volunteers and patients with osteoporosis the differences in the T2 of the fat component was significantly different.
In our preliminary experience MRS is helpful in the differential diagnosis of bony demineralization. It enables a differentiation between osteoporosis and diffuse multiple myeloma. T2 value measurements may be helpful in the diagnostic trial of osteoporosis.
评估体内1H磁共振波谱测定弛豫时间以及脂肪和水含量在鉴别腰椎X线表现为骨质脱矿但不明确的患者中多发性骨髓瘤浸润与骨质疏松方面的作用。
患者、材料与方法：对10例骨矿物质密度（BMD）降低的骨质疏松患者、经组织学证实的仅表现为弥漫性肿瘤表现而无脊柱肿瘤压缩性骨折的多发性骨髓瘤患者以及志愿者进行研究。骨质疏松通过双能X线吸收法（DXA）（Hologic QDR 2000设备，西门子医疗系统公司）确诊。磁共振检查使用1.5T全身系统（Gyroscan S15/ACS II，飞利浦医疗系统公司）进行。通过PRESS技术从约8cm3的立方体积中获取局部磁共振波谱。化学位移选择性T1弛豫时间通过反转恢复序列获得，T2通过在体积选择方案中改变第一个和第二个回波之间的间隔来测量。使用SPSS软件进行Kruskal-Wallis检验和Mann-Whitney检验进行统计分析。
骨质疏松患者与多发性骨髓瘤患者之间的T2值和脂肪含量存在高度显著差异。骨质疏松患者的T2值降低（分别为37ms和59ms，而浆细胞瘤患者为44ms和70ms），多发性骨髓瘤患者的脂肪含量降低（分别为20%，而志愿者和骨质疏松患者分别为31%和34%）。志愿者与骨质疏松患者之间脂肪成分的T2差异具有显著性。
根据我们的初步经验，磁共振波谱有助于骨脱矿化的鉴别诊断。它能够区分骨质疏松和弥漫性多发性骨髓瘤。T2值测量可能有助于骨质疏松的诊断试验。
