To different~atP multiple myelorna and metastasis of the spine, retrospective analysis of MR images of the patients with multifocal spinal involvement of multiple myelorna and metastasis was done. Analysis was done in view points of bone marrow involvement pattern(focal, diffuse, and mixed), margin, number, size and uniformity of the focal lesions, involvement of pedide and posterior element, and epidural and paravertebral mass formation.
Multiple myelorna predominantly showed diffuse pattem(11/21, 524%) of marrow involvement while metastasis showed mainly focal pattem(18/21, 85.7%), Margin of the focal lesions were distinct in majority(8/10, 80%) of multiple myeloma and indistinct in majority(16/21, 762%) of metastasis. , Size of the focal lesions were smaller in cases of multiple myeloma than those of metastass, but number and standard deviation of the size of the focal lesions did not show significant difference between the two diseases. Involvement of posterior element were more common in multiple myeloma, and epidural mass formation and paravertebral mass formation were more common in metastasis.
The authors concluded that the diffuse pattern of marrow involvement alone suggests multiple myekma. When a focal or a mixed pattern is found, distinct margin and smaller focal lesions are suggestive of multiple myeloma, and indistinct margin and larger focal lesions and epidural/paravertebral mass formation are suggestive of metastasis.
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