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目的探讨附件骨MRI表现在脊椎骨髓瘤、转移瘤鉴别中的价值。方法分析侵及附件骨的脊椎骨髓瘤、转移瘤各32例,包括病变的数目、部位、形态、大小、分布范围、纵向弛豫时间以及椎弓根、椎板截面直径等方面。结果32例脊椎骨髓瘤中,双侧附件破坏21例,单侧破坏11例,共检出病灶89个。形态呈团状、结节状者39个,呈斑片状28个,既有团状,又有斑片状者12个。受侵椎弓根、椎板、棘突与上一个相邻正常脊椎相比,其比值介于1.048~2.135之间。骨髓瘤与转移瘤侵及附件骨的数目、形态、分布特征有显著差异(P<0.001),椎弓根、椎板截面直径比有差异(P<0.05)。结论脊椎骨髓瘤、转移瘤附件骨MRI表现的差异性,有助于二者鉴别。
Objective To investigate the MRI features of accessory bone in the differential diagnosis of spinal myeloma and metastatic tumor. Methods Thirty - two cases of myeloma and metastatic tumor involving invading bone were included in this study. The number, location, shape, size, distribution range, longitudinal relaxation time and the diameter of pedicle and lamina were all analyzed. Results 32 cases of spinal myeloma, bilateral attachment destruction in 21 cases, unilateral destruction in 11 cases, a total of 89 lesions were detected. The shape of a group, nodular 39, 28 were patchy, both the group size, there are 12 patchy. Invasive pedicle, lamina, spinous process compared with the previous adjacent normal spine, the ratio between 1.048 ~ 2.135. There was significant difference (P <0.001) in the number, shape and distribution of bone invasion and metastasis between myeloma and accessory bone, and the cross-sectional diameter ratio of pedicle and lamina was significant difference (P <0.05). Conclusion The MRI findings of spinal myeloma and metastatic accessory bone are helpful to distinguish the two.