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目的:探讨 SPECT 对多发性骨髓瘤(MM)的诊断价值。方法:30例经临床确诊为 MM 的患者,均行SPECT 检查、骨髓穿刺涂片或活检及相关实验室检查,判断 SPECT 骨显像对 MM 的诊断价值,并用 SPECT 骨显像对部分患者追踪观察,评价 SPECT 对 MM 患者的动态监测作用。结果:30例 MM 患者中,29例 SPECT 骨显像表现为全身骨骼多处非对称性骨质代谢异常,其中以肋骨、脊柱代谢异常为多见。对2例进行追踪观察,治疗后半年复查SPECT 骨显像示骨质代谢异常范围缩小,骨髓穿刺示病情好转;另有2例患者 SPECT 骨显像示骨质代谢异常浓聚处超过30个。结论:SPECT 骨显像是 MM 重要的辅助检查之一,其特点为灵敏度高,特异性差,故须紧密结合临床,以提高 MM 的正确诊断率。
Objective: To investigate the diagnostic value of SPECT in multiple myeloma (MM). Methods: Thirty patients diagnosed as clinically diagnosed as MM underwent SPECT, bone marrow biopsy or biopsy and related laboratory tests to determine the diagnostic value of SPECT bone imaging in MM. Some patients were followed up by SPECT bone imaging , To evaluate the dynamic monitoring of SPECT in patients with MM. Results: Of 30 MM patients, 29 cases of SPECT bone scintigraphy showed multiple asymmetric skeletal metabolism abnormalities in the whole body. Among them, abnormal metabolism of ribs and spine was common. The follow-up observation of 2 cases showed that the range of abnormal bone metabolism was narrowed and bone marrow puncture showed improvement in the second half of the year after treatment. In another 2 cases, SPECT bone imaging showed more than 30 abnormalities of bone metabolism. CONCLUSIONS: SPECT bone imaging is one of the important auxiliary examinations of MM. It is characterized by high sensitivity and poor specificity, so it must be closely combined with clinical practice to improve the correct diagnosis rate of MM.