【摘要】 目的探讨多发性骨髓瘤(multiplemyeloma,MM)的99Tcm-甲氧基异丁基异腈(MIBI)显像特点及临床应用价值。方法注射99Tcm-MIBI555MBq后10min进行全身显像,根据图像特点分为4种表现类型:即N、D、F和F+D型,并依据显像范围(E)和程度(Ⅰ)对图像进行半定量计分及与临床血液学指标的相关分析。正常对照者12例,患者组42例。在随访中,对42例MM患者共进行了113人次的99Tcm-MIBI显像。结果不同临床分期、不同疾病状态的图像表现形式和半定量计分差异均有显著性。若以D、F、F+D型图像和综合计分≥2作为MM未完全缓解的判断标准,其诊断准确性为97.6%(80/82);而99Tcm-MIBI显像阴性(N型)或图像虽表现为D型,但综合计分≤2作为MM完全缓解的判断标准,其诊断准确性为100%(31/31)。图像半定量计分与血液中M蛋白含量及骨髓浆细胞数量呈正相关,与外周血血红蛋白含量呈负相关。结论99Tcm-MIBI显像能有效评估肿瘤负荷量及其活动程度。更多还原

【Abstract】 Objective To investigate the characteristics of 99Tcm-methoxyisobutylisonitrile (MIBI) imaging in patients with multiple myeloma (MM) and its clinical value. Methods Anterior and posterior whole-body imagings of 54 cases were obtained 10 min after intravenous injection of 555 MBq Tcm-MIBI. The images were classified as pattern N, D, F and F + D, and were also graded semiquantitatively according to distribution extent (E) and intensity of uptake (Ⅰ) of 99Tcm-MIBI in bone marrow, the bone marrow semi-quantitative scores and clinical hematological parameter correlated. Totally 12 normal controls and 42 MM patients were included. Results Statistics showed that the patterns and semi-quantitative scores of the imaging significantly differed among patients in different stages and different clinical status. If pattern D, F, F + D and summed score ≥2 was considered as criteria for non-remission, the diagnostic accuracy of 99Tcm-MIBI imaging reached 97. 6% (80/82). If pattern N or D with a summed score ≤2 was considered as criteria for complete remission, then the diagnostic accuracy was 100% (31/31). Moreover, significant positive correlation between the scores and both the percentage of bone marrow plasma cells and blood M protein were found, whereas a significant negative correlation was observed between the scores and peripheral blood hemoglobin levels. Conclusion 99Tcm-MIBI imaging is an effective and reliable method in evaluation of myeloma cell mass and clinical activity of disease and also plays a potential role in therapeutic monitoring.更多还原