SPECT骨显像对多发性骨髓瘤诊断的应用

Application of SPECT bone scan for multiple myeloma

目的 :研究SPECT骨显像对多发性骨髓瘤 (multiplemyeloma ,MM)的诊断价值。方法 :4 6例经临床确诊为MM的患者 ,均行SPECT骨显像、X线平片检查、骨髓穿刺涂片或活检及相关实验室检查 ,结合骨穿及其它检查结果 ,分析SPECT骨显像对MM的诊断意义 ,并用SPECT骨显像对部分患者进行追踪观察 ,评价SPECT骨显像对MM治疗效果的动态监测作用。结果 :4 6例MM患者中 ,有 4 4例SPECT骨显像表现为全身骨骼多处骨质代谢异常 ,大部分患者表现为全身多处骨质代谢异常 ,其中以脊柱、双肋、骨盆骨质代谢异常为多见。对 2例患者进行追踪 ,1例治疗后复查SPECT骨显像示骨质代谢异常的范围缩小 ,骨髓穿刺证实病情好转 ;1例复查SPECT骨显像示骨质代谢异常的范围明显扩大 ,患者病情加重 ,不久死亡。结论 :SPECT骨显像是MM极重要的辅助检查之一 ,其灵敏度高 ,但诊断必须结合临床。

Objective To study the diagnostic value of SPECT for multiple myeloma (MM). Methods Single photon emission computed tomography (SPECT) bone scan, marrow puncturing, x ray and other related examinations were performed in 46 patients with MM. We analysed the diagnostic value of SPECT bone scan combined with marrow puncturing and other examinations for MM. Some patients were examined with SPECT bone scan in order to estimate the efficacy of MM. Results SPECT bone scan images of 44 patients were abnormal in the 46 patients with MM. The masculine rate was 95.6%. In most of the patients, there was multiple abnormal osseous metabolism in the whole body, especially in the spine, double ribs, and pelvis. We observed the efficacy of 2 patients with SPECT bone scan. After the therapy, SPECT bone scan was performed again in 1 patient, and the image showed that the range of abnormal osseous metabolism was reduced; SPECT bone scan was performed again in the other patient, and the abnormal range was found to have increased obviously. Conclusion SPECT bone scan is one of the important assistant examination methods for MM. Its sensitivity is high. The nuclear medical diagnoses should be combined with clinical documents. SPECT bone scan might be available for monitoring the efficacy of MM.