CAJ | 학술논문

目的：探讨多发性骨髓瘤（ MM）骨质破坏及其治疗后的CT征象。方法收集25例MM治疗前后的CT资料，对比观察骨质破坏情况。结果25例MM骨质破坏呈弥漫性分布，其中2例呈骨质疏松状，3例呈膨胀状，20例呈虫噬状或穿凿状（3例合并膨胀状骨质破坏）；骨质破坏内充填软组织（3例有残存钙化），21例骨质破坏边缘模糊，6例骨质破坏周围见软组织肿块。治疗后表现：治疗有效21例，表现为骨质破坏消失（1例）、缩小（5例）、不变（15例），其中17例骨质破坏边缘变清晰伴骨质硬化，10例骨质破坏内出现斑块状或云絮状钙化，3例软组织肿块缩小，1例骨质疏松消失；治疗无效4例，表现为骨质破坏及软组织肿块增大或增多。结论 CT能清晰显示MM骨质破坏及其治疗变化情况，治疗后大部分破坏灶呈治疗有效表现，包括破坏灶大小不变或缩小、边缘逐渐清晰伴有骨质硬化，破坏灶内可出现钙化，但破坏灶完全消失少。
목적：탐토다발성골수류（ MM）골질파배급기치료후적CT정상。방법수집25례MM치료전후적CT자료，대비관찰골질파배정황。결과25례MM골질파배정미만성분포，기중2례정골질소송상，3례정팽창상，20례정충서상혹천착상（3례합병팽창상골질파배）；골질파배내충전연조직（3례유잔존개화），21례골질파배변연모호，6례골질파배주위견연조직종괴。치료후표현：치료유효21례，표현위골질파배소실（1례）、축소（5례）、불변（15례），기중17례골질파배변연변청석반골질경화，10례골질파배내출현반괴상혹운서상개화，3례연조직종괴축소，1례골질소송소실；치료무효4례，표현위골질파배급연조직종괴증대혹증다。결론 CT능청석현시MM골질파배급기치료변화정황，치료후대부분파배조정치료유효표현，포괄파배조대소불변혹축소、변연축점청석반유골질경화，파배조내가출현개화，단파배조완전소실소。
Objective To explore the CT manifestations of bone destruction in multiple myeloma( MM )before and after treatment. Methods The CT data on 25 patients with MM before and after treatment were collected in order to observe and compare the bone destruction. Resuits The bone destruction in 25 cases was distributed diffusely,including osteoporosis in two cases,expansion in three cases,moth eaten or punched pattern in 20 cases( with expansion in three cases);bone destruction filled with soft tissue( with residual calcification in three cases),bone destruction with fuzzy edge in 21 cases and with soft tissue mass surrounded in six cases. Post-treatment manifestations:the treatment was effective in 21 cases,showing that bone destruction disappeared( in one case )and narrowed( in five cases),and was unchanged( in 15 cases),including clear bone destruction edge with bone sclerosis in 17 cases,bone destruction with plaque or cloudy calcifications in 10 cases,tissue mass reduction in three cases,and osteoporosis disappearance in one case. The treatment was ineffective in four cases,showing that bone destruction and soft tissue mass increased or enlarged. Conciusion CT shows clearly the curative effect on bone destruction in MM. After the treatment,most of the damage range shown that the treatment is effective,including:the bone destruction ranges are unchanged or reduced,and the edges become clear gradually with bone sclerosis,and calcification occurs in the damaged ranges,but few damaged rages disappear completely.