The Correlation Between M Protein Typing And Imaging Characteristics Of Multiple Myeloma

Part one:The correlation between M protein typing and imaging characteristics of multiple myelomaObjective To explore the correlation between M protein typing and imaging features of multiple myeloma,in order to improve the imaging diagnosis of multiple myeloma,and play an important auxiliary role in clinical diagnosis and treatment.Methods Retrospective analysis of 104 cases of pathologically and clinically diagnosed multiple myeloma patients with imaging data.including 87 cases of X-ray examination;100 cases of CT examination,95 cases of plain scan,5 cases of plain scan + enhancement scan;49 cases of MRI examination,45 cases of plain scan,4 cases of plain scan + enhancement scan.X-ray,CT and MRI images were read by two imaging surgeons on the PACS system by double-blind method.The osteoporosis,bone destruction,pathological fracture,soft tissue mass and extramedullary diseases were observed in each patient.A comparative analysis of M protein typing of multiple myeloma was performed to investigate the correlation between M protein typing and imaging characteristics of multiple myeloma.Results Of the 104 patients with MM,48(46.1%)were Ig G,28(26.9%)were Ig A,22(21.2%)were light chain,6(5.8%)were Ig D,Ig M,Ig E,double clone or Polyclonal and non-secretory types were all 0 cases.Imaging findings of 104 patients: 93 cases of osteoporosis;94 cases of bone destruction,including 34 cases of skull bone destruction,94 cases of spinal bone destruction,94 cases of rib bone destruction and 65 cases of pelvic bone destruction There were 62 cases of pathological fractures,including 46 cases of ribs,31 cases of vertebral compression fractures,1 case of sternal fractures,1 case of right clavicle fractures,1 case of left femoral neck fractures,and 36 cases of left femoral neck fractures.Soft tissue masses occurred,8 of which occurred in multiple sites,27 cases in the ribs,10 cases in the vertebral body,5 cases in the humerus,other parts such as the left humeral head and the humeral shaft in 1 case,and 2 cases in the sternum.There were 1 case of left femoral neck and 16 cases of extramedullary lesions,including 8 cases of chest and pleura,6 cases of central nervous system and meninges,7 cases of subcutaneous soft tissue and muscle,3 cases of maxillofacial region and 1 case of lymph nodes.There was no statistically significant differences in osteoporosis,bone destruction,soft tissue mass and pathological fractures in multiple myeloma with different M protein types(P>0.05),The difference of extramedullary diseases in multiple myeloma with different M protein typing was statistically significant(P<0.05),And extramedullary diseases have certain predilection sites,which occured in the pleura,subcutaneous soft tissue and muscle,central nervous system.Conclusion M protein typing of multiple myeloma has a certain correlation with imaging characteristics,and Ig D type is more prone to extramedullary diseases than other types.Part two:Imaging features of extramedullary diseases in multiple myelomaObjective To explore the imaging features of extramedullary diseases in order to improve the understanding of extramedullary lesions of myeloma.Methods Retrospective analysis of 16 cases of pathologically diagnosed multiple myeloma with extramedullary diseases in clinical and imaging examinations,including 15 cases of CT examination,10 cases of plain scan,5 cases of plain scan + enhancement,8 cases of MRI examination,4 cases of plain scan,plain scan + enhancement of 4 cases,two imaging doctors used double-blind method to read CT and MRI images on PACS system,Observe the location,quantity,morphology,margin,density,signal and enhancement of EMD in each patient,and measure the size and CT value.All T1 WI and T2 WI signals were compared with adjacent skeletal muscle signals,To explore the imaging features of extramedullary diseases.Results Of the 16 patients,6 occurred in the central nervous system: 3 in the meninges(2 in single,1 in multiple);1 in the spinal canal;1 in the left bony;1 in the left frontal There were 1 case of communicative growth alone;3 cases of single head and neck,1 case was located around the left mandibular branch,1 case was located in the left masseter muscle,1 case was located in the right mandibular branch;8 cases occurred in the chest: There were 6 cases of pleura(5 cases with multiple cases,1 case with single shot),1 case with single in the lung,1 case with anterior mediastinum,5 cases with subcutaneous soft tissue,2 cases with single muscle,and 1 with multiple lymph nodes.Occurred in the meninges,pleura,subcutaneous soft tissue and lymph nodes,CT showed soft tissue nodules or masses,clear boundaries,regular shape,occurred in muscles or other parts,some borders are not clear,irregular shape,CT value 30 ~ 70 HU,more common in 30 ~ 45 HU,MRI T1 WI or a slightly lower signal,T2 WI or a slightly higher signal,DWI showed a high signal,enhanced moderate to significant enhancement.Conclusion Extramedullary diseases can occur in any part,but the pleural,meninges and subcutaneous soft tissues are the most common.CT and MRI can show the number,location,size,shape and relationship with extramedullary diseases.It has certain reference value for the diagnosis and differential diagnosis of extramedullary diseases.