MR-IMAGING OF MULTIPLE-MYELOMA PATIENTS WITH BONE-MARROW TRANSPLANTS

Purpose: To evaluate the role of MR imaging in the examination of mult iple myeloma (MM) patients with bone-marrow transplants. Material and Methods. A total of 40 MR examinations were made of 20 patients: 33 ex aminations of the spine and pelvis in 20/20 patients; and 7 examinatio ns of the femora in 5/20 patients. The 40 examinations were evaluated and the results compared with those found at radiography. Altogether 1 3/20 patients were re-examined: 10 after 1 year (1 patient twice); and 3 after 2 years. Five sequences were tested, 3 of them first without and then with i.v. contrast enhancement. Results: In 24/33 examination s, active MM lesions were shown by MR. In 16/33 examinations, MR showe d greater spread and detectability than radiography. In the 5/20 femor al patients, 3 had a peripheral red bone-marrow extension in the femor a. In the 13 re-examinations, the lesions had spread in 4 patients, we re unchanged in 7, and had decreased in 2. The lesions were easier to detect with the turbo inversion recovery (TIR) technique and with fat saturation than with the conventional spin-echo sequences. Contrast en hancement made the lesions more conspicuous in 8/17 examinations. Conc lusion: MR has the potential to be a useful routine examination with T 1-weighted and TIR sequences of selected areas, and without the use of contrast enhancement. However, further longitudinal studies are neces sary in order to evaluate its possible predictive value.