SPECT/CT骨显像在多发性骨髓瘤诊断中的临床应用

The clinical application of SPECTCT bone scan in diagnosis of multiple myeloma

目的:研究多发性骨髓瘤(MM)SPECT/CT骨显像的影像学特征,探讨SPECT/CT在多发性骨髓瘤中诊断中的临床应用价值。方法:回顾性分析31例确诊多发性骨髓瘤患者SPECT/CT骨显像的表现特征,分析融合显像对多发性骨髓瘤的诊断意义,并对部分患者进行动态观察,评价其在疗效监测中的作用。结果:①31例患者骨显像阳性率80.6%,共发现病灶130个,以脊柱、肋骨最常累及,绝大多数表现为放射性核素浓聚(128个),仅2个病灶表现为放射性分布减低;②SPECT/CT融合断层显像23例次,对于平面显像难以诊断的59处,明确鉴别了良恶性53处;对于6例单发病灶患者给出了明确诊断;③11例患者共行23次动态显像,结果提示4例病情好转,7例病情加重。结论:SPECT/CT骨显像对于多发性骨髓瘤骨病的诊断及疗效监测具有较高的临床应用价值。

Objective：To study the imaging characteristic of SPECTCT bone scan for multiple myeloma（MM）and to explore the value of the clinical applications of SPECTCT in diagnosis of MM.Methods：31 patients with MM underwent SPECTCT bone scan.A retrospectively analysis was performed to evaluate the role of the fusion imaging.Some patients were dynamically examined with SPECTCT bone scan to estimate its value of therapeutic response.Results：① The positive rate of bone scan in 31 patients was 80.6%,and 130 lesions were detectable,spine and ribs were involved most frequently.Most of the lesions showed high uptake of radionuclide（128）,only 2 lesions showed decreased radionuclide uptake;② The number of SPECTCT fusion imaging was 23.For the 59 lesions indeterminate in planar imaging,a clear identification of the benign and malignant was made in 53 lesions and 6 patients with solitary lesion particularly;③ 23 dynamically imaging were performed in 11 patients,and the results showed that 4 patients were improved and the other were in progress.Conclusion：SPECTCT bone scan has important values in diagnosis and efficacy monitoring for MM.