核素骨显像在多发性骨髓瘤诊断中的应用

Application of Radionuclide Bone Imaging in the Diagnosis of Multiple Myeloma

目的:探讨核素骨显像在多发性骨髓瘤(MM)诊断中的应用。方法:回顾性分析25例经骨髓穿刺证实的MM患者的骨显像表现,并与近期X线检查结果比较。结果:①25例患者中,骨显像异常17例,阳性率68.0%,肋骨、脊柱最常受累,162处病灶表现为异常放射性聚集,其中,肋骨病灶呈串珠样,胸骨及椎体病变呈扁平状或线状,4处表现为异常放射性减低;②X线片阳性率68.0%(17/25例),与骨显像相同,主要表现为骨质疏松、病理性骨折、骨破坏或呈混合性改变,共同检测的部位中,X线片检出的病灶总数较骨显像多(162和144),但骨显像检出肋骨和胸骨病灶较X线片多。结论:核素骨显像对MM的辅助诊断具有重要的意义,尤其是肋骨及胸骨病灶,其检出率优于X线检查。

Objective： To study the application of radionuclide bone imaging in diagnosing multiple myeloma. Method： 25 patients with multiple myeloma confirmed by marrow puncturing were performed radionuclide bone imaging and radiography, The results of two studies were analysed retrospectively. Result： ①Out of 25 patients, 17 exhibited myeloma -related bone lesions on radionuclide imaging, the positive rate was 68.0%, ribs and spine were involved most frequently, 162 lesions showed high uptake of radionuclide, the lesions lied in ribs appeared as strings of pearls, and those in sternums and vertebrae showed linear high uptake, the other 4 showed decreased radionuclide uptake. ③The positive rate on radiography was 68.0% （ 17/ 25） ,which was the same as that on radionuclide imaging, the patterns were osteoporosis, pathological fracture,osteolysis or two or two and above of these appearances, radiography detected more abnormalities than radionuclide imaging in identical sites （162 versus 144） , but radionuclide imaging detected more lesions than radiography in ribs and sternums. Conclusion： Radionuclide bone imaging is of importance in multiple myeloma,and is superiored to radiography in detecting lesions in ribs and sternums.