脊柱孤立性浆细胞瘤的临床及影像学特点分析  

The clinical features and imageological findings of solitary plasmacytoma of spine

作　　者：李万里[1] 宋跃明[1] 

机构地区：[1]四川大学华西医院骨科,610041

出　　处：《中国矫形外科杂志》2005年第13期969-972,共4页Orthopedic Journal of China

摘　　要：目的:探讨脊柱孤立性浆细胞瘤的临床及影像学特点。方法:分析经手术病理检查证实的6例脊柱孤立性浆细胞瘤病例的临床特点及影像学特征。结果:病椎附近逐渐加重的疼痛是其共同首发临床表现。其X线片多表现为椎体的溶骨性破坏;ECT上表现不一;CT多为椎体骨质的虫嗜状破坏;MRI示病椎信号失均,T1WI低信号,T2WI等或稍高信号,增强扫描有不均匀强化。结论:CT及MRI可明确脊柱孤立性浆细胞瘤的形态特征及病灶范围,其确诊仍需借助骨髓活检或手术标本病理检查。但对颈背部疼痛的患者,早期行MRI检查有助于及时发现病变,避免严重脊柱脊髓损害的出现。Objective:To discuss the clinical features and imageological findings of solitary plasmacytoma of spine.Method:Six cases of solitary plasmacytoma of spine with pathological identification were reviewed and the radiological features from X-rays,CT,MRI and ECT were compared respectively.Result:Pain nearby the involved vertebra was one of the common features of solitary plasmacytoma of spine.The occurrence of neurological compromise was mostly decided by the destroying extent of the vertebra and the structural instability of the spine.The features of solitary plasmacytoma of spine from the X-ray checking showed the destroying of the vertebra,while the features from ECT showed different results ; most of CT results illustrated the destroying of the vertebra as well,and higher or lower density of radiograph images were found inside the involves vertebra; the MRI scanning also showed different intensity inside the involved vertebra,low in T1 weighted and high on T2 weighted images.Conclusion:Although morphological features and involved regions of the tumor can be detected by CT and MRI scanning,the final diagnosis of solitary plasmacytoma of spine still needs the pathological checking of the bone marrow.To the back pain patients,early stage MRI checking is helpful to prevent severe destruction of the spine.

关 键 词：孤立性浆细胞瘤 脊柱 特点分析 首发临床表现 病理检查 影像学特点 影像学特征 溶骨性破坏 MRI检查 临床特点 T1WI T2WI 增强扫描 病灶范围 形态特征 手术标本 骨髓活检 背部疼痛 脊髓损害 X线片 ECT 低信号 高信号 椎体 

分 类 号：R738.1[医药卫生—肿瘤]