What are the benefits of MRI in the diagnosis of multiple myeloma?

Updated: Mar 15, 2019
  • Author: Michael E Mulligan, MD; Chief Editor: Felix S Chew, MD, MBA, MEd  more...
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Answer

Answer

MRI is an additional imaging examination to be used in patients with myeloma. MRI has the advantage of rapidity and sensitivity for the presence of disease; however, specificity is limited. Whole body imaging is preferred, but if this is not possible, at least an MRI examination of the spine should be done, because radiographically occult lesions or extramedullary lesions may be found that can change the stage and influence the need for therapeutic intervention. Extramedullary disease has been detected in as many as 50% of patients and is an independent predictor of a poorer prognosis. [19]

(See the images below displaying different areas of the body affected by multiple myeloma.)

Lateral radiograph of the skull. This image demons Lateral radiograph of the skull. This image demonstrates numerous lytic lesions, which are typical for the appearance of widespread myeloma.
Lateral radiograph of the lumbar spine. This image Lateral radiograph of the lumbar spine. This image shows deformity of the L4 vertebral body that resulted from a plasmacytoma.
Radiograph of the right femur. This image demonstr Radiograph of the right femur. This image demonstrates the typical appearance of a single myeloma lesion as a well-circumscribed lucency in the intertrochanteric region. Smaller lesions are seen at the greater trochanter.
Radiograph of the right humerus. This image demons Radiograph of the right humerus. This image demonstrates a destructive lesion of the diaphysis. Pathologic fracture is seen.
A T1-weighted magnetic resonance image of the hume A T1-weighted magnetic resonance image of the humerus. This image demonstrates a predominantly hypointense to isointense myelomatous lesion in the medullary space of the diaphysis. The lesion extends through the anterior aspect of the cortex.
A T1-weighted magnetic resonance image of the shou A T1-weighted magnetic resonance image of the shoulder. This image shows the full extent of myelomatous involvement within the glenoid and coracoid process.

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