【摘要】 目的 探讨多发性骨髓瘤的全身骨显像表现及骨显像对多发骨髓瘤骨损害的探测价值。方法 46例多发性骨髓瘤患者按常规进行全身骨显像,显像剂^99mTc-MDP,其中22例有详细的X线检查结果。结果 ①多发性骨髓瘤骨显像阳性率69.6％（32/46）。②骨显像大多表现为多发性异常浓聚骨病灶,以肋骨最为多见,其余依次为胸椎、颅骨、腰椎、骨盆、四肢近端。③5例（10.9％）骨显像表现为顶骨放射性均匀增高,形似“帽状”;5例（10.9％）表现为双侧肱骨头和/或双侧股骨头放射性对称性异常增高。④X线检查阳性而骨显像阴性18.2％,多见于颅骨;骨显像阳性而X线检查阴性22.7％,多见于肋骨及肱骨头和股骨头;骨显像与X线检查结果大致相同者36.4％,多见于脊柱和骨盆;骨显像病灶多于X线检查者22.7％,多见于肋骨及四肢;未见骨显像病灶较X线检查少的患者。结论 ①多发性骨髓瘤全身骨显像的阳性率为69.6％。②多发性骨髓瘤的骨显像大多表现为全身多发放射性浓聚灶,多见于躯干骨,颅骨及双侧肱骨头和股骨头也较常见。③多发性骨髓瘤的骨显像可能有一定的特征性表现:颅项骨的“帽状”征及双侧肱骨头和/或双侧股骨头放射性对称异常增高。④骨显像与常规X线检查对多发性骨髓瘤的骨损害探测各有所长,二者相互补充,骨显像可以作为探测多发性骨髓瘤更多还原

【Abstract】 Purpose To evaluate radionuclide bone scanning in patients with multiple myeloma(MM) for detecting bone lesions. Methods 46 patients with MM underwent y-camera after injection of 99mTc - MDP,22 of them underwent radiography. Results CD The sensiliviry of bone scit-nigraphy for MM was 69.6% . (2) Most of scintigraphy showed multiple local bone lesions where uptake was increased significantly. The bone lesions detected in rib 34.1%, thoracic verterae 18%, lumbar verterae 11.4%,skull 11.4% ,pelvis 9.5% ,head of humerus and femur 9.5% , respectively . (3) Uniformly increased uptake at skull, which looked like a cap, and symmetrically increased uptake at the heads of bilateral humeruses and/or femurs can be seen in 10.9% of scintigrapty respectively.(4) positive radiology and negtive scintigraphy in 18.2% patients, whose bone lesions often located in skull; positive scintigraphy and negtive radiography in 22.7% patients, lesions often in rib and head of humerus and femur, agreenment between scintigraphy and radiography in 36.4% patients,lesions often in spine column and pelvis;radionuclide imaging detected more bone lesions in 22.7% patients;no radiography showed more bone lesions than radionuclide imaging. Conclusions The cap-like sign in skull and symmetrically increased uptake at the heads of bilateral femeruses and/or burners may be specific in bone scaning of patients with MM. Bone scaning may be useful as adjunct to radiography and be acted as a routine tool for detecting bone lesions in patients with MM.更多还原