MRI IN PLASMACYTOMA - RANKING OF VARIOUS SEQUENCES IN VARIOUS INFILTRATION PATTERNS

Purpose: The aim of this study was to compare various pulse-sequences employing the spine array coil while considering the different infiltr ation patterns in multiple myeloma, in order to develop a fast and cos t effective screening method. Materials and methods: In a prospective study, 50 patients with histologically proven multiple myeloma were ex amined with the following standardised sequences: T-1-weighted SE, T-2 -weighted FSE, opposed phase GRE, FSE STIR, T-1-weighted SE post gadop entate dimeglumine without and with fat saturation. The images were ev aluated in a ROC analysis by three radiologists in consensus with a 5- grade scale separatively for diffuse and focal involvement. The gold s tandard 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 T-1-w SE -Sequent images. The sensitivity can be increased by contrast material application and signal intensity measurements; A combined focal and d iffuse infiltration and a ''salt and pepper'' pattern can be diagnosed with the combination of T-1-w SE-Sequent and FSE STIR sequences. Conc lusion: With T-1-weighted SE-Sequent sequences pre-and post-contrast a nd FSE STIR all therapeutical relevant infiltration patterns of plasmo cytoma can be identified and bone marrow screening of the spine can be carried out with an acquisition time of 5.58 minutes.