American Journal of Roentgenology, Vol 160, 1049-1052, Copyright © 1993 by American Roentgen Ray Society

ARTICLES

Detection of multiple myeloma involving the spine: efficacy of fat- suppression and contrast-enhanced MR imaging

A Rahmouni, M Divine, D Mathieu, M Golli, TH Dao, N Jazaerli, MC Anglade, F Reyes and N Vasile
Department of Radiology, Hopital Henri Mondor, Creteil, France.

OBJECTIVE. To determine the efficacy of fat-suppressed sequences and contrast-enhanced MR imaging for the detection of focal spinal lesions caused by multiple myeloma, we obtained MR images in 32 patients with newly diagnosed myeloma who had back pain. SUBJECTS AND METHODS. All patients had biopsy-proved myeloma and had MR imaging at the painful level of the spine. Spin-echo T1-weighted, T2-weighted, and short TI inversion-recovery (STIR) images; dynamic ultrafast low-angle shot (turbo-FLASH) images after IV injection of a bolus of paramagnetic contrast material; and contrast-enhanced T1-weighted images were obtained. We qualitatively compared the signal intensities and contrast enhancement of focal lesions with those of the surrounding vertebral bodies. RESULTS. Multiple lesions were detected in all but two of the 32 patients. On T2-weighted and STIR images, all lesions had homogeneously high signal intensity. On T1-weighted images, the lesions were visible as hypointense areas compared with surrounding bone in all except four patients, in whom the lesions were isointense or hyperintense. All tumor nodules enhanced on turbo-FLASH images obtained in the arterial phase. No additional lesions were seen on STIR or contrast-enhanced images. MR findings resulted in a change in the staging of the disease in one patient and led to prompt treatment in five patients with epidural involvement. CONCLUSION. MR imaging appears to be helpful in detecting spinal involvement in patients with multiple myeloma. The diagnosis of spinal lesions is best achieved by using either fat-suppressed or T2-weighted images. Although myeloma lesions enhanced in all patients, contrast material appears to be of no value for the detection of additional lesions.
CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

				J. Hillengass, K. Wasser, S. Delorme, F. Kiessling, C. Zechmann, A. Benner, H.-U. Kauczor, A. D. Ho, H. Goldschmidt, and T. M. Moehler Lumbar Bone Marrow Microcirculation Measurements from Dynamic Contrast-Enhanced Magnetic Resonance Imaging Is a Predictor of Event-Free Survival in Progressive Multiple Myeloma Clin. Cancer Res., January 15, 2007; 13(2): 475 - 481. [Abstract] [Full Text] [PDF]

				A.J. Johnson, J. Ying, T. El Gammal, R.D. Timmerman, R.Y. Kim, and B. Littenberg Which MR Imaging Sequences Are Necessary in Determining the Need for Radiation Therapy for Cord Compression? A Prospective Study AJNR Am. J. Neuroradiol., January 1, 2007; 28(1): 32 - 37. [Abstract] [Full Text] [PDF]

				H. J. Seol, S. S. Kim, J. E. Kim, S. H. Lee, and J. Y. Won Inflammatory Pseudotumor in the Epidural Space of the Thoracic Spine: A Case Report and Literature Review of MR Imaging Findings AJNR Am. J. Neuroradiol., November 1, 2005; 26(10): 2667 - 2670. [Abstract] [Full Text] [PDF]

				E. J. C. Angtuaco, A. B. T. Fassas, R. Walker, R. Sethi, and B. Barlogie Multiple Myeloma: Clinical Review and Diagnostic Imaging Radiology, April 1, 2004; 231(1): 11 - 23. [Abstract] [Full Text] [PDF]

				J.-L. Montazel, M. Divine, E. Lepage, H. Kobeiter, S. Breil, and A. Rahmouni Normal Spinal Bone Marrow in Adults: Dynamic Gadolinium-enhanced MR Imaging Radiology, December 1, 2003; 229(3): 703 - 709. [Abstract] [Full Text] [PDF]

				A. Rahmouni, J.-L. Montazel, M. Divine, E. Lepage, K. Belhadj, P. Gaulard, M. Bouanane, M. Golli, and H. Kobeiter Bone Marrow with Diffuse Tumor Infiltration in Patients with Lymphoproliferative Diseases: Dynamic Gadolinium-enhanced MR Imaging Radiology, December 1, 2003; 229(3): 710 - 717. [Abstract] [Full Text] [PDF]

				M. Castillo, A. Arbelaez, J. K. Smith, and L. L. Fisher Diffusion-weighted MR Imaging Offers No Advantage over Routine Noncontrast MR Imaging in the Detection of Vertebral Metastases AJNR Am. J. Neuroradiol., May 1, 2000; 21(5): 948 - 953. [Abstract] [Full Text]

				J. Breslau, J. G. Jarvik, D. R. Haynor, W. T. Longstreth Jr, D. L. Kent, and K. R. Maravilla MR Contrast Media in Neuroimaging: A Critical Review of the Literature AJNR Am. J. Neuroradiol., April 1, 1999; 20(4): 670 - 675. [Abstract] [Full Text]

				L. A. Moulopoulos and M. A. Dimopoulos Magnetic Resonance Imaging of the Bone Marrow in Hematologic Malignancies Blood, September 15, 1997; 90(6): 2127 - 2147. [Full Text] [PDF]