脊椎多发性骨髓瘤与溶骨性转移瘤的 CT 鉴别诊断  

CT differentiation between vertebral multiple myeloma and osteolytic metastasis

作　　者：马青[1] 刘吉华[1] 陈海松[1] 郝大鹏[1] 赵晓丹[1] 

机构地区：[1]青岛大学附属医院放射科,山东 青岛,266003

出　　处：《实用放射学杂志》2016年第8期1254-1257,共4页Journal of Practical Radiology

摘　　要：目的：探讨脊椎多发性骨髓瘤（VMM）与溶骨性转移瘤 CT 征象差别。方法回顾性分析32例 VMM 与52例脊椎溶骨性转移瘤患者的 CT 表现,对不同的征象进行记录和统计学分析。结果32例 VMM 累及220个脊椎,52例转移瘤累及167个脊椎。椎体内多发小圆型骨质破坏 VMM 发生率42.66%（93/218）,高于脊椎转移瘤0.00%（0/165）（χ2=92.963,P =0.000）。不规则型骨质破坏 VMM 发生率23.39%（51/218）,低于脊椎转移瘤45.45%（75/165）（χ2=20.704,P =0.000）。嵴状突起型骨质破坏VMM 发生率16.06%（35/218）,高于脊椎转移瘤9.10%（15/165）（χ2=4.013,P =0.045）。碎片型骨质破坏 VMM 发生率8.7%（19/218）,低于脊椎转移瘤27.27%（45/165）（χ2=23.238,P =0.000）。单侧椎弓根受累 VMM 发生率6.82%（15/220）,低于脊椎转移瘤17.96%（30/167）（χ2=11.477,P =0.001）。结论VMM 与脊椎溶骨性转移瘤二者的 CT 征象具有一定特征,结合临床特点可作出鉴别诊断。Objective To explore the imaging differences of vertebral multiple myeloma（VMM）and vertebral osteolytic metastasis on CT. Methods Review the imaging signs of 32 patients with VMM and 52 patients with vertebral osteolytic metastasis,then record and finally statistical analysis was carried out.Results Compare to 1 67 vertebras involved in 52 cases of vertebral metastasis,the patents with VMM had 220 vertebras involved.The incidence of the multiple small circular type of bone destruction in VMM was 42.66%（93/218）,which was higher than that in vertebral metastasis 0.00% （0/165）（χ2 =92.963,P =0.000）.The incidence of the irregular shape type of bone destruction in VMM was 23.39% （5 1/218）,while it was higher in patients with vertebral metastasis 45.45%（75/165）（χ2 =20.704,P=0.000）.It was also found that the incidence of the fragmentary type of bone destruction and the involvement of the unilateral pedicle in VMM were lower than that in patients with vertebral metastasis 8.7% （19/218 ）＆amp; 27.27% （45/165）（χ2 =23.238,P =0.000）, 6.82% （1 5/220）＆amp; 1 7.96% （30/1 67）（χ2 =1 1.477,P =0.001）.The incidence of the crest protrusion type of bone destruction in patients with VMM was 16.06% （35/218）,however it was 9.10% （15/165）（χ2 =4.013,P =0.045）in vertebral osteolytic metastasis. Conclusion The imaging features of VMM and vertebral osteolytic metastasis had certain characteristic.And they can be differentiated from each other,combining with clinical traits.

关 键 词：脊椎多发性骨髓瘤 溶骨性 转移瘤 计算机体层成像 

分 类 号：R733.3[医药卫生—肿瘤] R814.42[医药卫生—临床医学]