摘要
目的研究多发性骨髓瘤(MM)患者治疗前后99mTc-MDP全身骨显像的表现特征和变化,探讨骨显像在MM骨病诊断和疗效评判中的应用。方法研究86例MM患者的99mTc-MDP全身骨显像表现特征,并与X线摄片结果对比观察,治疗中动态监测全身骨显像变化。结果86例患者用骨显像监测多发性骨髓瘤骨破坏的阳性率为97.7%,共发现病灶447处,脊柱、肋骨最易受累。其中87.7%骨显像异常表现为放射性浓集:肋骨多为多处点状放射性浓集,脊柱为多处条状放射性浓集。12.3%病灶为放射性减低。骨显像比X线摄片发现病灶多,其与X线摄片发现病灶的符合率为45.3%。治疗监测:缓解期患者有74.3%(26/35例次)可见原病灶放射性浓集程度减低,检查13例次进展期MM骨显像示病灶数增多。结论放射性核素全身骨显像对MM的诊断具有重要价值,对MM疗效的动态观察具有监测意义,99mTc-MDP全身骨显像可作为MM诊断和疗效观察的常规手段之一。
Objective To study the application of radionuclide bone imaging in multiple myeloma and to probe into the clinical evaluation in scintigraphic images for diagnosis and treatment of multiple myeloma. Methods Eighty-six patients with MM underwent radionuclide bone scanning after injection of ^99mTc-MDP; all of them underwent radiography. The results of two studies were analysed. Some patients were dynamically examined with radionuclide bone imaging in order to estimate the treatment efficacy of MM. Results Positive bone scintigraphy was 97.7%, and 447 lesions were detectable, spine and ribs were involved most frequently; 87.7% areas of increased uptake was revealed on scintigraphic images： multiple tiny spots increased radioactive uptake in the lesions were observed in ribs, multiple stripped increased radioactive uptake were observed in spine, 12.3% bone lesions represented areas of decreased uptake. Scintigraphic images was more sensitive to bone lesions than radiography. The concordance of both scintigraphic images and radiography was 45.3 %~. Inspected after therapy： the range of abnormal osseous metabolism reduce in 74.3 % remission patients, the range of abnormal osseous metabolism increase in 13 cases of relapsed patients. Conclusion Radionuclide bone scanning has vital value in diagnosis of MM, and is useful for follow-up of the case of MM after therapy. Radionuclide bone scanning may be act as routine tool for detecting bone lesions in patients with MM.
出处
《中国医学影像技术》
CSCD
北大核心
2008年第7期1106-1109,共4页
Chinese Journal of Medical Imaging Technology
