脊柱孤立性浆细胞瘤的临床及影像学特点分析The clinical features and imageological findings of solitary plasmacytoma of spine
李万里,宋跃明
摘要(Abstract)：
目的:探讨脊柱孤立性浆细胞瘤的临床及影像学特点。方法:分析经手术病理检查证实的6例脊柱孤立性浆细胞瘤病例的临床特点及影像学特征。结果:病椎附近逐渐加重的疼痛是其共同首发临床表现。其X线片多表现为椎体的溶骨性破坏;ECT上表现不一;CT多为椎体骨质的虫嗜状破坏;MRI示病椎信号失均,T1WI低信号,T2WI等或稍高信号,增强扫描有不均匀强化。结论:CT及MRI可明确脊柱孤立性浆细胞瘤的形态特征及病灶范围,其确诊仍需借助骨髓活检或手术标本病理检查。但对颈背部疼痛的患者,早期行MRI检查有助于及时发现病变,避免严重脊柱脊髓损害的出现。
关键词(KeyWords)： 孤立性浆细胞瘤;脊柱;影像学
基金项目(Foundation):
作者(Author): 李万里,宋跃明
Email:
DOI:
参考文献(References)：
- 〔1〕 Richard Soutar,Graham Jackson,Graham Jackson,et al.Guidelines onthe diagnosis and management of solitary plasmacytoma of bone and solitary extramedullary plasmacytoma[J].Clinical oncology,2004,16:405~413.
- 〔2〕 杨迪生,范顺武,陶惠民,等.骨的孤立性浆细胞瘤和髓外浆细胞瘤[J].中华肿瘤杂志,1996:18(1):41~44.
- 〔3〕 Vijaya-sekaran S,Delap T,Abramovich S.Solitary plasmacytoma of the skull base presenting with unilateral sensorineural hearing loss[J].J Laryngol Otol,1999,113:164~166.
- 〔4〕 Wilder RB,Ha CS,Cox JD,et al.Persistence of myeloma protein for more than one year after radiotherapy is an adverse prognostic factor in solitary plasmacytoma of bone[J].Cancer,2002,94:1532~1537.
- 〔5〕 徐宏光,王以朋,邱贵兴,等.颈胸腰椎骨髓瘤的外科治疗[J].中华医学杂志,2002,82(16):1118~1120.
- 〔6〕 朱明旺,戴建平,陆荣庆,等.脊柱孤立性浆细胞瘤的MR表现[J].实用放射学杂志,2000,16(1):9~11.
- 〔7〕 Tsang RW,Gospodarowicz MK,Pintilie M,et al.Solitary plasmacytoma treated with radiotherapy:impact of tumour size on outcome[J].Int J Radiat Oncol Biol Phys,2001,50:113~120.
- 〔8〕 Dimopoulos MA,Moulopoulos LA,Maniatis A,et al.Solitary plasmacy-toma of bone and asymptomatic multiple myeloma[J].Blood,2000,96:2037~2044.