Value of Magnetic Resonance in Examination of the Spine in Patients with Multiple Myeloma
Vytřasová M., Ščudla V., Nekula J.,Bučil J.,Vavrdová V., Bačovský J
III. interní klinika Lékařské fakulty UP a Fakultní nemocnice, Olomouc, přednosta prof. MUDr. V. Ščudla, CSc. Radiologická klinika Lékařské fakulty UP a Fakultní nemocnice, Olomouc, přednosta prof. MUDr. J. Nekula, CSc. |
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Summary:
Multiple myeloma (MM) is a malignant disease of the haematopoietic system characterized by the
formation of osteolytic foci of the skeleton with predilection of the thoracolumbar portion of the
spine. The submitted investigation evaluates the importance of examination of the spine by magnetic resonance (MR), as compared with results of conventional radiology (CR). The analyzed
group of 75 patients with multiple myeloma was assembled in the course of the previous four
years. All patients were examined by conventional radiology and magnetic resonance and the
assembled results were mutually compared. On examination by MR a pathological finding was
recorded in 68/75 (91 %) patients, when using CR in 41/75 (55 %) patients. Compression of the
vertebral bodies was assessed by means of magnetic resonance in 42/75 (56 %) patients, when
using CR in 37/75 (49 %) patients. Secondary stenosis of the spinal canal was detected by MR in
23/75 (30 %), extramedullary spread of myelomatous masses was found in 15/75 (20 %) patients
whereby radiographic examination was negative in these patients. Osteolytic foci in the area of
the spine were recorded in 62/75 (83 %) patients examined by MR, while by using CR only in 3/75
(4 %). From the presented results ensues that nuclear magnetic resonance is for evaluation of
spinal lesions in MM much more sensitive than conventional radiography, mainly due to the
possibility of direct visualization of soft tissue tumourous masses and evaluation of their relationship to the spinal canal. The contribution of MR examination is invaluable in particular in
patients with obscure back pain and a negative finding on radiographic examination of the skeleton where X-ray examination does not explain adequately the patient´s complaints, as well as in
patients with suspected compression of the spinal cord. In some liminal situations it contributes
to more accurate assessment of the clinical stage and thus to selection of adequate treatment.
Key words:
Multiple myeloma - Magnetic resonance - Conventional radiography - Compression of
the spine
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