摘要
目的探讨多发性骨髓瘤(MM)的核素全身骨显像和X线影像特征,评估核素骨显像在MM骨病诊断中的临床应用价值。方法对49例多发性骨髓瘤患者53例次99mTc-MDP核素骨显像与X线摄片结果进行对比研究。结果1核素全身骨显像阳性率为84.8%(151/178个),共发现病灶151个。X线摄片阳性率为56.7%(101/178个),共发现病灶101个。两种显像的诊断符合率为41.6%(74/178个)。2对受检病例骨损害的好发部位及频率的统计表明:核素显像依次为脊柱(37.1%)、肋骨(25.2%)、骨盆(10.6%)、长管状骨6.6%、肩关节及肩胛骨(6.6%)、颅骨(3.3%);X线摄片结果为脊柱(36.6%)、肋骨(15.8%)、颅骨(14.9%)、骨盆(14.9%)、长管状骨(8.9%)、肩关节及肩胛骨(4.0%)。核素显像对肋骨病灶的显示较X线更敏感,而颅骨病变则更适于行X线检查。核素骨显像对X线阳性的不同影像特征病灶的检出率亦不同(P<0.01),分别为病理性骨折100%、溶骨性破坏68.4%、弥漫性骨质疏松62.5%。3X线摄片和核素骨显像相结合与单独X线摄片(部分加做局部CT或MRI)探测骨损害对受检病例MM分期结果有一定影响。结论核素骨显像与常规X线摄片检查对多发性骨髓瘤的骨损害探测各有所长,二者相互补充,核素骨显像可以作为探测多发性骨髓瘤骨损害的常规方法。
Objective To compare the different images of bone scintigraphy and radiography in patients with multiple myeloma（MM） and to probe into the clinical evaluation for detecting bone lesions in MM. Methods 48 patients with MM underwent 53 times radionuclide bone scanning after injection of 99m^Tc-MDP, all of them underwent radiography in one week. Results ①Positive bone scintigraphy was 84.8% （151/178）,and 151 lesions were detectable. While plain X-rays had a positive rate of 56.7% （101/ 178）, 101 lesions were detectable. The concordance of both scintigraphy and radiography was only 41.6% （74/178）. ② With scintigraphy, the frequencies of bone lesions involved were spine column （37.1%）, ribs（25.2%）, pelvis（10.6%）, scapula（6.6%）, humerus and femur （6.6%）, skull （3.3%）. whereas, it were spine column （36.6%）, ribs （15.8%）,skull （14.9%）,pelvis （14.9%）,humerus and femur（8.9%）, scapula （4.0%）with plain X-rays. The results showed that scintigraphy was sensitive to rib while X-ray was sensitive to skull. The concordance of both scintigraphy and radiography in detecting osteoporosis, lytic lesions and pathologic fractures are 100%, 68. 4% and 62. 5%, respectively. ③The results of scintigraphy plus radiography for detecting bone lesions is not always the same with X-ray only, which can influnces the clinical staging of MM. Conclusion It is equal of importance for patients with MM to undergo radionuclide bone scanning and radiography. Bone scintigraphy may be useful as adjunct to radiography and be acted as a routine tool for detecting bone lesions in patients with MM.
出处
《国际输血及血液学杂志》
CAS
2006年第2期97-100,共4页
International Journal of Blood Transfusion and Hematology
关键词
多发性骨髓瘤
放射性核素显像
X线摄影
Multiple Myeloma（MM）
99m^Tc-MDP
bone scintigraphy radiography
