以脊柱病变为主的骨髓瘤的诊断  

Diagnosis of Myeloma Which lesion is Mainly in Spine

作　　者：牟永忠[1] 

机构地区：[1]浙江医院,浙江杭州310031

出　　处：《实用骨科杂志》2002年第4期263-264,共2页Journal of Practical Orthopaedics

摘　　要：目的 :探讨骨髓瘤的诊断 ,以免误诊、漏诊或进行不必要的手术。方法 :本组患者 43例 ,临床表现有颈肩、胸腰背痛 ,表现为双下肢不全瘫者有 15例。全部病例进行了X线摄片及MRI检查 ,经皮穿刺活组织检查 2 6例。结果 :经皮穿刺活检 19例发现浆细胞明显增多 ,有异型性。骨髓检查 40例 ,其中有 18例发现浆细胞达 10 %以上并有形态异常 ,11例浆细胞达 5 %以上。MRI检查 41例发现信号异常 ,18例椎体有楔形变。结论 :MRI检查可早期发现骨髓瘤 ,并有助于与骨质疏松症、脊柱结核及成骨性肿瘤鉴别。骨髓检查可明确诊断 ,经皮穿刺活检 。Objective:To discuss diagnosis of myeloma in order to avoid misdiagnosis or making unnecessary operation.Methods:A group of 43 cases were included in this study.Clinical manifestation was neck-shoulder pain,thoracico-back pain or lumber back pain.Lower limb paralysis were appeared in 15 cases.X-ray and MRI examination were taken in all cases.Percutaneous biopsy in 26 casies.Results:Percutaneous biopsy were found that plasma cell increased in 19 cases.Bone marrow examination were found that plasma cell attained 10 percent in 18 cases,5 percent in 11 cases.MRI examination were found signal abnormal in 41 cases,Vertebra body were found wedge in 18 cases.Conclusion:MRI examination may found myeloma early and help to differentiate from spine TB,spine osteoblastoma and osteoporosis.Bone marrow examination may make diognosis accuratly.Percutaneous biopsy is an effective method,especially to diagnose single myeloma.

关 键 词：脊柱病变 诊断 骨髓瘤 经皮穿刺活检 MRI 

分 类 号：R733.3[医药卫生—肿瘤]