【摘要】 目的 观察多发性骨髓瘤在99mTc-MDP全身骨显像和局部ECT的影像特点，探讨骨显像对多发性骨髓瘤诊治的作用。方法 回顾性分析1998年7月～2004年9月在我院进行全身骨显像的36例多发性骨髓瘤患者，年龄32～80岁，由核医学医师集体阅片，结合X线影像表现、免疫球蛋白测定及相关实验室检查对异常影像进行诊断，所有患者皆经骨髓穿刺及(或)病理活检证实。结果 骨显像正常2例，骨显像表现为单发病灶8例，多发病灶26例。在单发病灶中的骨骼各部位分布为胸、腰椎各1例；左锁骨1例；骶骨3例，均为冷区表现；四肢骨2例，均伴有病理性骨折。在多发病灶中，骨骼易于受累的部位依次为：脊柱、肋骨、骨盆、四肢、肩胛骨、颅骨、锁骨和胸骨。7例患者在治疗后复查骨显像，5例明显好转。结论 全身骨显像是诊断多发性骨髓瘤的灵敏手段之一，且非常适用于治疗中的随访和疗效观察。充分了解疾病的骨显像影像特点，并结合X线表现和实验室检查有助于进一步鉴别诊断。在常规骨显像基础上适当应用断层显像可以提高诊断的准确性。

    【关键词】 多发性骨髓瘤；放射性核素；骨显像

    Application of radionuclide bone imaging in the diagnosis and monitoring of multiple myeloma

    YANG Fang，ZHANG Lian-na，PENG Jing-jing，et al.

    Department of Nuclear Medicine,Beijing Jishuitan Hospital,Beijing Institute of Traumatology and Orthopedics,4th Clinical Medical College of Beijing University,Beijing 100035,China

    【Abstract】 Objective To observe the characteristics of multiple myeloma on radionuclide bone imaging and to discuss the usefulness of bone imaging for multiple myeloma.Methods A retrospective study of 36 patients with multiple myeloma who underwent general bone imaging during the last 6 years were performed.Results Of total 36 patients,no abnormality was found in 2 patients,single lesions in 8 patients,and multiple lesions in 26 patients.7 patients had follow-up scans after therapy with 5 showing improvement.Conclusion Radionuclide bone imaging is a sensitive modality for multiple myeloma,and it is suitable for follow-up and effect observation during treatment. ......