When performing CT with a large degree of confidence It is intended to diagnose interstitial changes in the lungs in patients with MM: deformity of the pulmonary vascular pattern, pulmonary fibrosis, pulmonary emphysema. In patients with MM, even in the absence of a concomitant broncho-obstructive process, a large percentage of emphysematous transformed lung tissue is determined. As the tumor progresses, the percentage of emphysema increases. This was established using the method of emphysema detection when performing CT using the Hitachi W-800 computed tomography program using the Level Detect program. tomographic slice . According to CT data in patients with IA and IIA disease stages (I group), the percentage of emphysematous tissue per unit. area averaged 25.14 ± 0,22; in patients with stage IIIA (group II) – 41.7 ± 0.28%; in stage IIIB of the disease (group III) – 42.21 ± 0.22%.
Computed tomography is a verification method of radiological examination of the organs of the thoracic cavity in patients with MM complicated by CRF. The sensitivity of CT in the detection of pulmonary changes in patients with chronic renal failure increases significantly. When performing CT, it is possible to diagnose not only structural, but also functional changes in the lungs in patients with MM with the presence of renal failure. Computed tomography provides significant assistance in the diagnosis of pneumonia in patients with MM, developed on the background of agranulocytosis after cytostatic treatment. Due to the deficiency of neutrophils in these patients, it is very rarely possible to identify a clear inflammatory focus in a standard X-ray study. With CT, most of these patients still managed to determine the presence of infiltration.
Myeloma, proceeding from the pleura.
Summarizing the above, we can conclude the following:
1. The main radiological manifestations of pulmonary complications of multiple myeloma are: interstitial type of changes (increased pulmonary pattern, emphysema, pneumosclerosis), presence of destruction and ribs tumors, inflammatory infiltrates, nephrogenic pulmonary edema, fluid in the pleural cavities.
2. Computed tomography is the most effective method for detecting local pathological processes in the lungs with MM. CT is the leading method of X-ray diagnostics of pneumonia adhering against the background of agranulocytosis.
3. When using the method of quantitative evaluation of radiological data at CT in patients with MM, as the tumor progression revealed an increase in the percentage of emphysematous tissue.