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目的:探讨99mTc-MDP骨显像对多发性骨髓瘤(multiple myeloma,MM)骨病的诊断价值。方法:回顾分析了83例初诊的MM患者,均行全身99mTc-MDP骨显像,以X线检查部位为限定范围,与相应部位的骨显像结果进行比较分析。结果:99mTc-MDP骨显像阳性率为88.0%(73/83例),X线检查阳性率为73.3%(55/75例),低于骨显像的阳性率,但同时行头颅、胸片、腰椎及骨盆X线检查患者的X线检查阳性率与骨显像检查无显著差异(P=0.726)。99mTc-MDP骨显像对肋骨病变的阳性率高于X线(P<0.01),X线对头颅、骨盆病灶阳性率高于骨显像(P<0.01)。结论:99mTc-MDP骨显像与多部位的X线检查总的敏感性相似,但骨显像对肋骨病灶的敏感性优于X线,而X线则对检测头颅、骨盆病变更敏感,故两种检查方法相互结合,对不相符部位进一步行CT/MRI验证是提高MM骨病检出率的重要途径。
Objective: To investigate the diagnostic value of 99mTc-MDP bone imaging in multiple myeloma (MM). Methods: 83 cases of newly diagnosed MM patients were retrospectively analyzed. Whole-body 99mTc-MDP bone imaging was performed. The range of X-ray examination sites was defined and the bone imaging results of the corresponding sites were compared and analyzed. Results: The positive rate of 99mTc-MDP bone imaging was 88.0% (73/83 cases), the positive rate of X-ray examination was 73.3% (55/75 cases), which was lower than the positive rate of bone imaging, There was no significant difference in the positive rate of X-ray examination between the films, lumbar spine and pelvis X-ray examination and bone imaging (P = 0.726). The positive rate of 99mTc-MDP bone imaging for rib lesions was higher than that for X-ray (P <0.01). The positive rate of X-ray on skull and pelvis lesions was higher than that of bone imaging (P <0.01). Conclusions: 99mTc-MDP bone imaging is similar to multi-site X-ray examination, but bone imaging is more sensitive to rib lesions than X-ray, while X-ray is more sensitive to the detection of head and pelvic lesions. The two methods combined with each other, do not match the site further CT / MRI verification is an important way to improve the detection rate of MM bone disease.