SPECT骨显像诊断多发性骨髓瘤的临床价值.pdfVIP

· 238· 实用全科医学2008年3月第6卷第3期 Applied Journal of General Practice，March 2008，Vo1．6，No．3 【全科临床研究】 SPECT骨显像诊断多发性骨髓瘤的临床价值 申勇，周翔，陶新全，刘恒超，胡永全 【摘 要】 目的 研究SPECT放射性核素骨显像对于多发性骨髓瘤(MM)的诊断价值。方法 22例临床确诊为MM 的患者，均行SPECT全身骨显像检查，通过分析MM骨显像的显像特点并结合患者的x线平片．CT等其他相关检查，探 讨SPECT骨显像诊断MM的临床价值。结果 22例患者中，有20例SPECT骨显像表现为骨质代谢异常，阳性率 90．9％，共发现病灶246处，大多数表现为多发性异常浓聚(226处)和多发性浓聚合并放射性稀疏或缺损区(20处)。 部分患者的骨显像具有特征性表现，如“面圈征”8处，肋骨串珠样浓聚3例，颅骨“帽状征”5例。结论 SPECT全身骨 显像诊断多发性骨髓瘤阳性率为90．9％，常伴有特征性表现，其灵敏度高，一次成像可反映全身的骨骼代谢状况，能够 较早发现骨骼的病变，如果结合x线、CT等检查，相互补充，有助于提高MM的检出率。骨显像可以作为诊断MM重要 的常规检查之一。 【关键词】 多发性骨髓瘤；SPECT；放射性核素骨显像；诊断 【中图分类号】 R739．4 R817 【文献标识码】 A 【文章编号】 1672-1764(2008)03-0238-02 Clinical Assessment of SPECT Bone Scan in Diagnosis of Multiple Myeloma sHEN Yong．ZHOU Xiang，TAo X 一quan，et a1．Depaanwnt of Nuclear Medicine，Affiliated Hospital of Bengbu Medical College，Anhui 233004，China 【Abstract】Objective To study the diagnostic value of SPECT(Single photon emission computed tomography)bone scall for multiple myeloma(MM)．Methods AU 22 patients with MM performed the examinations of SPECT bone scall，we analysed the characteristic of the MM patient’S bone scan and combined with radiograph．CT and other related examinations and probed into the diagnostic value of SPECT for multiple myeloma。Results SPECT bone scan images of 20 patients were abnorm al among the 22 patients．the positive rate was 90 9％ We detected 246 focuses in all patients．Most of the bone scaII showed multiple abnor— mal increasing in the lesions．some of them combined with increasing and decreasing or defect of radioactive uptake in the lesions． Some exhibitions may be specific in bone scan of patients with MM．as the cap。like sign in skul1．Conelusions The sensitivity of bone scintigraphy f0r MM was 90 9％ ．its sensitivity is high．