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STUDY DESIGN: A prospective multicenter study. OBJECTIVES: To evaluate the use of magnetic resonance imaging, in the differentiation between monoclonal gammopathies of unknown significance and multiple myeloma. SUMMARY OF BACKGROUND DATA: Although multiple myeloma has been studied extensively with magnetic resonance imaging, to the authors' knowledge, no study has evaluated the clinical interest of magnetic resonance imaging in the differentiation between monoclonal gammopathies of unknown significance and multiple myeloma. METHODS: The magnetic resonance examinations of the thoracolumbar spine in 24 patients with newly diagnosed monoclonal gammopathies of unknown significance were compared with those performed in 44 patients with newly diagnosed nontreated multiple myeloma. RESULTS: All findings on magnetic resonance examination performed in patients with monoclonal gammopathies of unknown significance were normal, whereas findings on 38 (86%) of the 44 magnetic resonance examinations performed in patients with multiple myeloma were abnormal. CONCLUSION: Magnetic resonance imaging can be considered as an additional diagnostic tool in differentiating between monoclonal gammopathies of unknown significance and multiple myeloma, which may be helpful when routine criteria are not sufficient. An abnormal finding on magnetic resonance examination in a patient with monoclonal gammopathies of unknown significance should suggest the diagnosis of multiple myeloma after other causes of marrow signal abnormalities are excluded. Magnetic resonance imaging also may be proposed in the long-term follow-up of monoclonal gammopathies of unknown significance when a new biologic or clinical event suggests the diagnosis of malignant monoclonal gammopathy.

10 patients with symptoms of mandibular neuralgia formed the basis of this study. They were studied by both enhanced CT and MRI. MRI, better than CT, easily permits distinction between intrinsic and extrinsic lesions and detects involvement of the cavernous sinus and meninges. Moreover, because of its multiplanar imaging capability, and ability to portray exquisite anatomic details and characteristic tissue signal intensity, MRI is helpful in the evaluation of tumor involvement for biopsy and preoperative planning for these deep tumours.

✓ This report describes a patient with von Hippel—Lindau disease who presented with an 8-year history of a slow-growing, locally invasive vascularized lesion of the temporal bone involving the cerebellopontine angle. The mass, studied by computerized tomography scanning and magnetic resonance imaging techniques, was partly cystic in appearance. After removal of the mass, pathological studies confirmed a papillary cystic tumor with characteristics that have been described in tumors with an endolymphatic sac origin. These rare neoplasms constitute a distinct pathological entity and deserve wider recognition.

To distinguish malignant from osteoporotic acute vertebral collapses.Sixty-three osteoporotic and 30 malignant vertebral collapses were studied in 51 patients (aged 33-88 years) with T1-weighted magnetic resonance (MR) images (n=93), gadolinium-enhanced T1-weighted images (n=72), and T2-weighted images (n=53).Four findings were suggestive of osteoporosis: retropulsion of a bone fragment (10 osteoporotic cases vs 0 malignant cases), preservation of normal signal intensity on T1-weighted images (43 vs four), return to normal signal intensity after gadolinium injection (42 vs four) with horizontal bandlike patterns, and isointense vertebrae on T2-weighted images (28 vs two). Six findings were suggestive of malignancy: convex posterior cortex (21 malignant cases vs four osteoporotic cases), epidural mass (24 vs 0), diffuse low signal intensity within the vertebral body on T1-weighted images (23 vs 12) and in the pedicles (24 vs four), high or inhomogeneous signal intensity after gadolinium injection (17 vs 0) and on T2-weighted images (17 vs 0).Gadolinium-enhanced and unenhanced MR images are useful in the differentiation of vertebral collapses.