Rofo 2019; 191(09): 805-816
DOI: 10.1055/a-0864-2084
Review
© Georg Thieme Verlag KG Stuttgart · New York

Bildgebende Diagnostik des Multiplen Myeloms

Article in several languages: English | deutsch
Aleksander Kosmala
Department of Diagnostic and Interventional Radiology, University-Hospital Würzburg, Germany
,
Thorsten Bley
Department of Diagnostic and Interventional Radiology, University-Hospital Würzburg, Germany
,
Bernhard Petritsch
Department of Diagnostic and Interventional Radiology, University-Hospital Würzburg, Germany
› Author Affiliations
Further Information

Publication History

21 November 2018

06 February 2019

Publication Date:
11 June 2019 (online)

Zusammenfassung

Hintergrund Das Multiple Myelom ist eine maligne hämatologische Erkrankung, die sich durch die Proliferation von monoklonalen Plasmazellen vor allem im Knochenmark auszeichnet. Die Bildgebung spielt zur Diagnosestellung und Verlaufsbeurteilung eine wichtige Rolle.

Methode Dieser Übersichtsartikel informiert über das Krankheitsbild des Multiplen Myeloms samt Vorstufen und beschreibt die zur Verfügung stehenden bildgebenden Untersuchungstechniken. Diese werden samt Vor- und Nachteilen sowie möglichen prognostischen und therapeutischen Implikationen vor dem Hintergrund der aktuellen Literatur vorgestellt.

Ergebnisse und Schlussfolgerung Der konventionelle Röntgenstatus ist beim Multiple Myelom mittlerweile vollständig von Schnittbildtechniken ersetzt worden. Die breit verfügbare Ganzkörper-Computertomografie wird routinemäßig verwendet, um Osteolysen nachzuweisen. Die Magnetresonanztomografie hat die höchste Sensitivität zur Detektion von Knochenmarkbefall und wird insbesondere bei den Vorstufen des symptomatischen Multiplen Myeloms empfohlen. Die Positronen-Emissionstomografie vereint morphologische und funktionelle Bildgebung. Sie kommt vor allem bei der Verlaufsbeurteilung und Evaluation von Therapieansprechen zum Einsatz.

Kernaussagen:

  • Der konventionelle Röntgenstatus („Pariser Schema“) ist obsolet.

  • Die Detektion von Osteolysen geschieht mittels Ganzkörper-CT.

  • Die MRT hat die höchste Sensitivität zur Detektion von Knochenmarkbefall.

  • Bei Myelom-Vorstufen kommt die MRT (alternativ: PET/CT) zum Einsatz.

  • Die PET/CT wird zur Verlaufsbeurteilung und Therapieevaluation angewandt.

Zitierweise

  • Kosmala A, Bley T, Petritsch B. Imaging of Multiple Myeloma. Fortschr Röntgenstr 2019; 191: 805 – 816

 
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