【摘要】 目的:探讨多发性骨髓瘤(MM)的99Tcm-MIBI显像特点及临床应用价值。方法:正常对照组12例,病例组MM患者42例(Ⅰ期12例,Ⅱ期22例,Ⅲ期8例),其中初诊37例,复发5例。注射99Tcm-MIBI(555MBq)后10min进行全身成像,根据图像特点可分为4种表现类型,即N型、D型、F型和F+D型,依据显像的范围(E)和程度(I)对图像进行半定量计分,并分析其与临床血液学指标的相关性。结果:不同临床分期患者的图像表现形式和半定量计分均有显著差异。若以99Tcm-MIBI显像阳性(F、F+D型或D型并S>2)作为多发性骨髓瘤处于活动期的判断标准,其诊断准确性为100%,且图像计分与血液中M蛋白含量和骨髓中浆细胞含量呈正相关,而与外周血血红蛋白含量呈负相关。结论:在判断MM病灶的活动性及病情评估等方面,99Tcm-MIBI显像是一种简便、有效且可靠的方法。更多还原

【Abstract】 Objective: To evaluate the incidence of various patterns of 99Tcm;MIBI uptake in patients with multiple myeloma(MM) and its potential value in clinical use . Methods: Twelve normal control cases and forty;two (12 in stage Ⅰ, 22 in stage Ⅱ and 8 in stage Ⅲ) patients with MM were studied. Anterior and posterior whole;body scans were obtained 10 min after i.v. injection of 555 MBq of 99Tcm;MIBI. The scans were classified as follows : pattern N, pattern D, pattern F and pattern F+D. The scans were graded according to extension (E) and intensity (I) of the uptake. The relationships between bone marrow semi;quantitative scores and clinical and haematological variables were investigated. Results: Statistics showed that the distribution of the 99Tcm;MIBI uptake patterns and semi;quantitative scores differed among patients in different stages of disease . Using the presence of either focal uptake(pattern F or pattern F+D) or pattern D with a summed score >2 as criteria for active disease, all patients were correctly classified. Moreover, significant positive correlations with the amount of monoclonal component and the percentage of bone marrow plasma cells were found , and a significant negative correlation was observed between the scores and haemoglobin levels. Conclusion: 99Tcm;MIBI imaging is an effective and reliable method in determination of the activity and clinical status of MM.[更多还原