Clinic And Imaging Diagnosis Study On Multiple Myeloma

【Objective】Part one:Analysis of different age stages of the performance of spinal bone marrow MRI.To explore the law of transformation of spinal bone marrow on MRI and multiple myeloma and spinal bone marrow MR signal characteristics.Part two:Multiple Myeloma imaging features were retrospectively analyzed.To discuss the diagnostic value and the prioritization scheme of three examination ways on multiple myeloma.Improve the imaging diagnose level of Multiple Myeloma.【Materials and Methods】1.Selection of study objects and scanning sequencesPart one:A total of 80 cases of spinal patients of different age group and 20 cases of multiple myeloma bone marrow MR images.All cases of patients underwent the MR examinations with one 3.0T superconducting magnetic resonance imaging device (Signa Excited,GE;Magnetom vision plus,SIEMENS) with a standared quadrature body coil or pinal column privated coil for signal collection using the following sequences:sagittal spin-echo T₁-weighted.Part two:Imaging data of 60 cases with multiple myeloma confirmed by pathology and clinic were analyzed retrospectively during 2004 to 2009.Patients underwent the CT examinations with scanner(Somatom Plus 4,SIEMENS;Light speed VR 16,GE) or MR examinations with superconducting magnetic resonance imaging device(Signa Excited,GE;Magnetom vision plus,SIEMENS),CT enhanced scaning with hypertension injector,double phase or dynamic enhancement scanning,MR examination used different coil depending examination part,routine T₁-weighted,T₂-weighted,enhancement scanning with Gd-DTPA.2.Study method and statistic analysisPart one:Analysis the spine bone marrow MR signal and the evolution characteristics and multiple myeloma characterized on MRI.The relationship between Bone marrow MR signal typing performance and age was used Spearman correlation analysis.The control group and multiple myeloma vertebral group MRI typing performance were compared by two independent samples test,P＜0.05 the difference has statistical significance.Part two:Analyze the Multiple Myeloma imaging features on X ray,CT,MRI. Analyze the imaging typing of bone destruction of Multiple Myeloma. Compare the sensitivity,specificity,accuracy of three examination ways on multiple myeloma.Software package was applied for the above statistical analysis.Diagnose accordance rate of three examination ways were compared with Chi-square test.P＜0.05 the difference has statistical significance.【Results】Part one:The correlation analysis results between age and spine bone marrow MRI classification:Spearman correlation coefficient was 0.671,P＜0.001,spinal bone marrow MR signal typing and age was a significant positive correlation,with a moderate consistency(correlation coefficient 0.4～0.7).In case-control group of different age,spinal bone marrow signal on MRI were different.Generally speaking, as the age increased,signal intensity gradually increased gradually significant heterogeneity.MM group average rank was 61.63,case-control group average rank was 47.72.Mann-Whitney U statistic was 577.5,Z test statistic was Z=-2.024,P= 0.043＜0.05(bilateral).MM group and case-control group classification of spinal MRI has shown significant differences,In MM group spinal bone marrow MRI signal has specific performance and theâ…¢performance was mostly common.Part two:osteopathis location of multiple myeloma can be seen in vertebra,ribs, pelvis and skull mostly.The imaging manifestations of multiple myeloma were osteoporosis,destruction of bone,pathologic fracture,soft tissue mass,and oteosclerosis in a few patients.Radiography diagnosis sensitivity was 65.4%,and accuracy rating 82.4%,CT diagnosis sensitivity was 94.2%,and accuracy rating 94.1%,MRI diagnosis sensitivity was 100%,and accuracy rating 95.0%, Radiography combined with CT and MRI sensitivity was 100%.【Conclusions】Part one:With the age increased,spinal marrow signal transformed from the uniform clear signal to the non-uniform focal.Spine bone marrow MRI features were shown different at different aged groups.To diagnose MM must be considered with the patient ages.MRI features on MM has some specificity,significantly different with case-control groups.Part two:Multiple myeloma has its own imaging manifestation in bone destruction.Radiography has high spatial resolution and can reflect the whole body bone overall.CT and MRI have high sensitivity to early lesions,small lesions and soft tissue mass.CT and MRI examination is a complement to Radiography. Radiography combined with CT and MRI can improve the diagnostic accuracy to multiple myeloma.