CT Differentiation Between Vertebral Multiple Myeloma And Osteolytic Metastasis

Objective The study was to investigate the imaging differences of vertebral multiple myeloma and osteolytic metastasis on computed tomography(CT)and improve differential diagnostic ability by the representative signs.Methods Review the imaging signs of 32 patients with vertebral multiple myeloma and 52 patients with vertebral osteolytic metastasis,then record the signs and do statistical analysis.Results In 32 cases of vertebral multiple myeloma,220 vertebra were involved.In 52 cases of vertebral metastasis,167 vertebra were involved.The incidence of the multiple small circular type of bone destruction in vertebral multiple myeloma was 42.66%(93/218),it was higher than that in vertebral metastasis 0.00%(0/165).The incidence of the irregular shape type of bone destruction in vertebral mu ltiple myeloma was 23.39%(51/218),it was lower than that in vertebral metastasis 45.45%(75/165).The incidence of the crest protrusion type of bone destruction in vertebral multiple myeloma was 16.06%(35/218),it was higher than that in vertebral metastasis 9.10%(15/165).The incidence of the fragmentary type of bone destruction in vertebral multiple myeloma was 8.7%(19/218),it was lower than that in vertebral metastasis 27.27%(45/165).The incidence of the involvement of the unilateral pedicle destruction in vertebral multiple myeloma was 6.82%(15/220),it was lower than that in vertebral metastasis 17.96%(30/167).The incidence of the sparse bone trabecula of obscure destrucion in vertebral multiple myeloma was 49.48%(95/192),it was higher than that in vertebral metastasis 10.58%(40/378).Conclusion Vertebral multiple myeloma and osteolytic metastasis had some characteristic imaging features,combined with the clinical characteristic can they be differentiated from each other.