2016年 · 第50卷第09期

Gadolinium-ethoxybenzyl-diethylenetriaminepentaacetic acid (Gd-EOB-DTPA) is a hepatobiliary specific MRI contrast agent. Gd-EOB-DTPA obtained by adding fat-soluble ethoxybenzyl (EOB) to the molecular structure of Gd-DTPA has unique biological characteristics. Gd-EOB-DTPA, on the one hand, by shortening the tissue T₁Relaxation time, the multi-phase dynamic enhancement effect similar to that of Gd-DTPA can be obtained, so as to observe the conventional multi-phase dynamic enhancement mode and its manifestation of liver lesions; On the other hand, in patients with normal liver function, the liver parenchyma was enhanced to the maximum extent 10~20 min after Gd-EOB-DTPA injection, and the biliary system could also be developed. This phase is called hepatobiliary specific phase.

The patient was a 13-year-old female. He was admitted to hospital for half a month due to back pain and numbness in his left upper limb. Physical examination on admission: body temperature 36.2℃, slight tenderness and tapping pain in the spinous process of thoracic 3 (T3) vertebrae; neurological examination: bilateral biceps and triceps tendon reflexes, bilateral knee and Achilles tendon reflexes were not abnormal, and bilateral Babinski sign was negative. Laboratory examination: alkaline phosphatase and tumor markers were normal, serum phosphorus was 1.86 mmol/L, and white blood cells were 18.5×10^-9/L, absolute neutrophil 15.62×10^-9/L, the proportion of neutrophils was 86.5%. After 1 week of anti-inflammatory treatment, the absolute values of white blood cells and neutrophils and the ratio of neutrophils returned to normal.

Urinary melanosis is clinically rare. Two cases have been diagnosed in our hospital in recent years, which are reported below in combination with relevant literature.

Myeloma is a plasma cell dysplastic disease that occurs in the skull, clavicle, pelvis, spine, humerus, and proximal femur^[1,2,3]。 Myeloma with the first symptom in the sternum is rare. Radial periosteal reaction was observed in very few cases^[2,3,4,5]。 We diagnosed 2 cases, which are now reported below.

The patient was a 75-year-old male. He was admitted to hospital on August 2, 2013 due to frequent urination and macroscopic hematuria for more than 2 years, and persistent right low back pain for 1 week. The patient developed urgency with intermittent macroscopic hematuria without obvious trigger 2 years ago, with blood clots discharged, and no frequent or painful urination. Sudden severe colic in the right lumbar 1 week before admission, radiating to the right abdomen. Abdominal physical examination: The right middle and upper abdomen can palpable a cystic mass, tender, fluctuating sensation, and clear border. Right kidney area bulge, right upper ureter stroke tenderness, right kidney area percussion pain. No abnormalities were observed in the rest of the sites. Urinary routine: microscopic red blood cells 134×10⁶/L, leukocytes 27×10⁶Piece/L.