1. Role of MRI for the diagnosis and prognosis of multiple myeloma
Andrea Baur-Melnyk, Sonja Buhmann, H.R. Dürr, Maximilian Reiser 
European Journal of Radiology 
Volume 55, Issue 1, Pages (July 2005)
DOI: /j.ejrad
Copyright © 2005 Elsevier Ireland Ltd Terms and Conditions

2. Fig. 1
A 74-year-old female with an IgG-myeloma and focal infiltration in the bone marrow. Focal areas of low signal intensity on T1-weighted SE images correspond to areas of high signal intensity on STIR images.
European Journal of Radiology  , 56-63DOI: ( /j.ejrad )
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3. Fig. 2
T1-weighted SE images of three patients with diffuse infiltration by multiple myeloma. Low grade interstitial diffuse infiltration cannot be depicted with MRI, since vol% of plasma cells is too low to alter the signal and often the fat cell content is even increased in early stages (a). Intermediate grade of diffuse infiltration is characterized by lowering of signal on T1-weighted SE images, however there is still contrast to the lower water containing signal of the intervertebral disc (b). The fat cell content is reduced. In patients with high-grade diffuse infiltration the signal intensity is almost the same than the intervertebral disc, due to a packed marrow (c).
European Journal of Radiology  , 56-63DOI: ( /j.ejrad )
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4. Fig. 3
A 70-year-old male with IgG myeloma (stage I disease) and “salt-pepper”-pattern. The signal intensity on T1-weighted SE images is patchy, suspective of infiltration (a). However on STIR images (b) no focal herds can be depicted. This corresponds to normal bone marrow with only low grade diffuse infiltration beside focal fat islands, which can be clearly depicted as focal islands of hyperintense signal on T1-weighted SE images (a, arrows.).
European Journal of Radiology  , 56-63DOI: ( /j.ejrad )
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5. Fig. 4
X-rays of the lumbar spine of a 61-year-old female with newly diagnosed IgG multiple myloma. Osteochondrosis at the level L4/5 and slight scoliosis was observed. No osteodestructions are present. Whole body CT showed a large osteolysis of the fifth lumbar vertebral body with end-plate infraction (c, arrow). T1-weighted SE (d) and fat-saturated (STIR, e) images show again the large tumour infiltrate in the fifth lumbar vertebral body but also multiple tiny myeloma nodules all over the spine.
European Journal of Radiology  , 56-63DOI: ( /j.ejrad )
Copyright © 2005 Elsevier Ireland Ltd Terms and Conditions

6. Fig. 5
A 57-year-old female patient with newly diagnosed multiple myeloma. Reconstructed coronary CT (a) of the femura show inhomogeneous bone density but no definite osteolyses, whereas in MRI (T1-weight SE images, b) diffuse infiltration was present in the pelvis and the femura (arrows).
European Journal of Radiology  , 56-63DOI: ( /j.ejrad )
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7. Fig. 6
A 80-year-old female with Ig-G myeloma. T1-weighted SE images (a) show a complete tumourous infiltration of the first lumbar vertebral body showing hypointensity with replacement of fat cells (arrow). Corresponding STIR sequences show hyperintensity (b). Axial CT of this level demonstrates the massive osseous destruction with involvement of the cortex indicating severe fracture risk (c).
European Journal of Radiology  , 56-63DOI: ( /j.ejrad )
Copyright © 2005 Elsevier Ireland Ltd Terms and Conditions