目的 探讨X线和MRI在多发性骨 髓瘤(MM)诊断中的应用价值及影像表现。 方法 回顾性分析68例多发性骨髓瘤患 者的临床资料，其中X线检查54例，MRI 检查36例，分析68例MM患者累及部分分 布，两种影像学检查MM的显像特征比较 两者对MM检出率和诊断符合率。结果 68 例MM患者中54例经X线检查显示，表现为 骨质破坏42例，病理性骨折11例，骨质 硬化5例，软组织肿块13例，骨质疏松10 例，36例经MRI检查显示，弥漫型10例,局 灶型20例,弥漫加灶型4例,椒盐型8例。 MRI检出率和诊断符合率分别为100%和 97.2%，均显著高于X线检出率(61.1%)和 诊断符合率(78.8%)，差异具有统计学意 义(χ2 =16.152和4.051，P<0.05)。结论 MRI能够检测MM病变早期骨质破坏和骨髓 浸润，与X线比较，MRI技术能够提高MM患 者检出率和符合率，值得临床推广使用。

Objective To explore the application value and imaging findings of X-ray and MRI in the diagnosis of multiple myeloma (MM). Methods The clinical data of 68 patients with multiple myeloma were retrospectively analyzed, including 54 cases of X-ray and 36 cases of MRI. The involving parts distribution of 68 MM patients and the MM imaging characteristics of two imaging examinations were analyzed, and the detection rate and diagnostic accuracy of MM by two examinations were compared. Results 54 cases examined by X-ray among 68 MM patients showed that there were 42 cases of bone destruction, 11 cases of pathological fractures, 5 cases of bone sclerosis, 13 cases of soft tissue mass and 10 cases of osteoporosis. 36 cases by MRI examination showed that there were diffuse type in 10 cases, focal type in 20 cases, diffuse focus type in 4 cases, and salt and pepper type in 8 cases. The detection rate and diagnostic coincidence rate of MRI were 100% and 97.2%, respectively, which were significantly higher than those of X-ray with 61.1% and 78.8%(χ2 =16.152 and 4.051, P<0.05). Conclusion MRI can detect early bone destruction and bone marrow infiltration of MM lesions. Compared with X-ray, MRI can improve the detection rate and coincidence rate, therefore it is worthy of clinical promotion and application.