胸腰椎体多发性骨髓瘤和溶骨性转移瘤的CT影像特点研究  

Study on the CT imaging features of bone metastases and dissolution of vertebral body in multiple myeloma

作　　者：宋鑫[1] 魏君 杨新宇[1] 王建涛[1] 李俊涛[1] 

机构地区：[1]唐山市工人医院放射科,河北唐山063000 [2]唐山市工人医院神经外科一监护室,河北唐山063000

出　　处：《临床和实验医学杂志》2018年第1期100-102,共3页Journal of Clinical and Experimental Medicine

摘　　要：目的探讨胸腰椎体多发性骨髓瘤和溶骨性转移瘤的CT影像特点。方法选取2012年1月至2016年1月接受治疗检查的92例患者,其中多发性骨髓瘤患者40例(208个椎体发生破坏产生病变),溶骨性转移瘤52例(155个椎体发生破坏产生病变)。所有患者均经手术病理或骨髓涂片加以确诊,专业医护人员对所有患者进行CT检查,并由2位临床教授对CT影像进行分析诊断,详细记录患者的椎体受累数目、部位及详情、骨质破坏形态等信息。结果对实验结果进行统计比较,患者胸腰椎体受累部位Ⅰ型、Ⅱ型、Ⅲ型中,多发性骨髓瘤分别为6个(2.88%)、16个(7.69%)与186个(89.42%),溶骨性转移瘤分别为14个(9.03%)、41个(26.45%)与100个(64.52%),差异具有统计学意义(P<0.05)。多发性骨髓瘤患者椎体中硬化边缘、骨皮质破坏、单侧椎弓根破坏数目分别为13个(6.25%)、42个(20.19%)与14个(6.73%),明显低于溶骨性转移瘤患者24个(15.48%)、90个(58.06%)与28个(18.06%),差异具有统计学意义(P<0.05)。骨质破坏类型中多发性骨髓瘤患者的不规则状45个(21.63%)、碎片状18个(8.65%)数目明显低于溶骨性转移瘤患者70个(45.16%)与43个(27.74%),但嵴状突起状34个(16.35%)、小圆状87个(41.83%)数目明显高于溶骨性转移瘤患者13个(8.39%)与2个(1.29%),差异具有统计学意义(P<0.05)。结论胸腰椎体多发性骨髓瘤和溶骨性转移瘤患者的临床病情相似,医护人员可通过CT影像中的椎体受累部位及具体情况,骨质破坏形态加以鉴别,从而提高医护人员的诊断率。Objective To investigate the CT features of multiple myeloma and osteolytic metastases of thoracic and lumbar vertebrae. Methods 92 patients were selected from January 2012 to January 2016. Among them,there were multiple myeloma patients in 40 cases( 208 vertebral destruction occurred) and osteolytic metastases in 52 cases( 155 vertebral destruction occurred). All patients were confirmed by surgery or bone marrow smear diagnosis,health care professionals CT was performed in all patients,and by 2 clinical professors on CT image analysis and diagnosis,detailed record number,location and details of vertebral bodies in patients with bone destruction,such forms of information. Results The experimental results were compared,patients with thoracolumbar vertebral involvement site of type I and type II,type III,multiple myeloma were 6( 2. 88%),16( 7. 69%) and 186( 89. 42%),osteolytic metastases were 14( 9. 03%),41( 26. 45%) and 100( 64. 52%),the difference was statistically significant( P < 0. 05). Hardened edge,multiple myeloma patients with vertebral cortical bone destruction,unilateral pedicle destruction were 13( 6. 25%),42( 20. 19%) and 14( 6. 73%),which were significantly lower than those in patients with osteolytic metastases in 24( 15. 48%),90( 58. 06%) and 28( 18. 06%),the difference was statistically significant( P < 0. 05). The type of irregular bone destruction in multiple myeloma patients were 45( 21. 63%),18 pieces( 8. 65%),which were significantly lower than the number of osteolytic metastases in 70 patients( 45. 16%) and 43( 27. 74%),but the ridge like protrusions 34( 16. 35%),87( 41. 83%),which were significantly higher than those of osteolytic metastases were 13( 8. 39%) and 2( 1. 29%),the difference was statistically significant( P < 0. 05). Conclusion Thoracolumbar body multiple myeloma and osteolytic metastases in patients are with similar clinical symptoms,medical personnel can identify through the CT image of the affected area of vertebral bone destruction form and specific circumstances,so as to im

关 键 词：多发性骨髓瘤 溶骨性转移瘤 CT影像 

分 类 号：R730.44[医药卫生—肿瘤] R733.3[医药卫生—临床医学]