目的 探讨脊柱单发性浆细胞骨髓瘤的MRI表现,提高对该疾病的认识.方法 回顾性分析9例经手术及病理证实的脊柱单发性浆细胞骨髓瘤的MRI表现.结果 所有患者均为单发病变,年龄41～68岁,平均年龄51.6岁,男女比例2:1.1例发生在颈椎、6例发生在胸椎、1例发生在腰椎,1例发生在骶椎.病椎附近疼痛是其共同的首发症状,9例尿本一周氏蛋白均为阴性.MRI显示病变椎体均出现溶骨性骨质破坏,7例累及椎体附件,1例椎体压缩性骨折,8例骨质破坏并软组织肿块,增强扫描软组织肿块明显强化.T1WI、T2WI椎体信号不均匀,无骨髓水肿,相邻椎间隙信号未见改变.5例软组织肿块突入椎管内,椎管变窄并脊髓受压,局部受压3例,肿块环绕脊髓四周者2例呈围管征,增强扫描瘤体及脊膜均明显强化,可显示类似脊膜尾征.结论 脊柱孤立性浆细胞骨髓瘤的MRI表现上具有一定特征.MR能够清楚地显示肿瘤的骨髓侵润及其与周围组织的关系,显示脊髓受压.并有助于与其他单发脊柱肿瘤鉴别.MRI检查有助于提高诊断准确性.%Objective To explore the imaging presentation of solitary plasmacytoma of bone (SPB).Methods Clinical and imaging data of 9 patients with SPB confirmed by surgery or histopathological examination were collected and analyzed retrospectively.Results All patients had single lesion and located in the vertebrae,including 1 in cervical vertebrae,6 in thoracic vertebra,1 in lumbare vertebrae and 1 in sacral vertebrae.The male to female ratio was 2:1.The age of the patients ranged from 41 to 68 (mean age=51.6 years).The urine Bence-Jones protein in ale patients was negative.The common symptom was pain in the surrounding regions.MRI can clearly show the soft tissue mass,spinal involvement and spinal cord compression.The bone marrow and surrounding Soft tissue invasion were displayed clearly by MRI,but the signals of lesions were various.Conclusion All borders are well defined by MRI.MRI can depict the morphological features and extent of regions clearly and MRI can provide a lot of information for diagnosis of plasmcytoma.Clinical and relative laboratory examination resulis are also helpful in improving diagnostic accuracy.
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