[Magnetic resonance tomography in plasmacytoma: ranking of various sequences in diffuse and focal infiltration patterns].
OBJECTIVE
The aim of this study was to compare various pulse-sequences employing the spine array coil while considering the different infiltration patterns in multiple myeloma, in order to develop a fast and cost effective screening method.


METHODS
In a prospective study, 50 patients with histologically proven multiple myeloma were examined with the following standardised sequences: T1-weighted SE, T2-weighted FSE, opposed phase GRE, FSE STIR, T1-weighted SE post gadopentate dimeglumine without and with fat saturation. The images were evaluated in a ROC analysis by three radiologists in consensus with a 5-grade scale separatively for diffuse and focal involvement. The gold standard was bone marrow histology in cases of diffuse infiltration and the combination of all sequences with the staging system according to Durie and Salmon.


RESULTS
For focal bone marrow involvement the area under curve was greatest for FSE STIR sequences, in cases of diffuse infiltration the area under curve was superior for unenhanced T1-w SE-Sequenz images. The sensitivity can be increased by contrast material application and signal intensity measurements. A combined focal and diffuse infiltration and a "salt and pepper" pattern can be diagnosed with the combination of T1-w SE-Sequenz and FSE STIR sequences.


CONCLUSIONS
With T1-weighted SE-Sequenz sequences pre- and post-contrast and FSE STIR all therapeutical relevant infiltration patterns of plasmocytoma can be identified and bone marrow screening of the spine can be carried out with an acquisition time of 5.58 minutes.
Baur
A
A
Institut für Radiologische Diagnostik, Klinikum Grosshadern, München.
Stäbler
A
A
Steinborn
M
M
Schnarkowski
P
P
Pistitsch
C
C
Lamerz
R
R
Bartl
R
R
Reiser
M
M
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003287:Contrast Media; D005189:False Positive Reactions; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000175:diagnosis* / Q000473:pathology; D010954:Plasmacytoma / Q000175:diagnosis* / Q000473:pathology; D015203:Reproducibility of Results
D003287:Contrast Media
Magnetresonanztomographie beim Plasmozytom: Wertigkeit verschiedener Sequenzen bei diffuser und fokaler Infiltrationsform.