腰椎骨髓逆转换的MR表现及相关常见病因分析

目的研究腰椎骨髓逆转换MR表现及其常见病因的鉴别诊断。方法搜集唐山人民医院行腰椎MR检查并出现骨髓逆转换征象住院患者14名的临床、实验室及影像资料。其中腰椎转移瘤6例,多发骨髓瘤2例,骨髓纤维化1例,恶性肿瘤化疗后5例。结果5例腰椎椎体表现为于T1WI呈均匀一致低信号,于T2WI呈均匀一致高信号。9例于T1WI表现等信号背景下可见多个斑片状、斑点状低信号,于T2WI呈等信号背景下可见多个斑片状、斑点状高信号,数目不等,散在分布。其中3例附件受累,1例椎旁形成肿块,1例硬膜外形成肿块。结论腰椎转移瘤、多发骨髓瘤、骨髓纤维化、恶性肿瘤化疗后腰椎等疾病均可发生骨髓逆转换,其MR表现缺乏特异性,诊断需结合临床、实验室及其他检查才能明确诊断。

MR Manifestation of Lumbar Myeloid Inverse Conversion and Analysis Common Pathogeny

Objective:To investigate MR manifestation of lumbar myeloid inverse conversion and differential diagnosis of common pathogeny.Methods:To collect the clinical,laboratory and image data of 14 patients which MR manifest lumbar myeloid inverse conversion in our hospital,among them 6cases of metastatic tumor,2cases of multipl myeloma,1 cases of myelofibrosis,5cases of tumor after chemotherapy.Results:5 cases' lumbar MR manifest uniformity hypo-signal in T1WI,uniformity hypo-signal in T2WI.9 cases' lumbar MR manifest multiple patchy and mottling hypo-signal under equi-signal background in T1WI,and isparate numerus hypo-signal under equi-signal background in T2WI,among them 3cases involved in lumbar accompaniment,2cases emerged tumeur in the side of the lumbar and in epidural space respective.Conclusion:Lumbar myeloid inverse conversion generated in the patients of metastatic tumor,multiple myeloma,myelofibrosis and tumor after chemo-therapy,which MR manifestation is less of specific characteristic,definitely diagnoses required to combined with the data of clinic,laboratory and examination.