血液病外周性骨髓显像变化规律及临床意义的研究  

STUDY ON PERIPHERAL EXPANSION OF BONE MARROW IN HEMATOLOGIC PAINTS AND ITS CLINICAL APPLICATION

作　　者：刘勇[1] 刘岱[1] 康福[1] 贾士铨[1] 张一帆[1] 韩建奎[1] 李梦龙[1] 陈万传 

机构地区：[1]山东医科大学核医学教研室,山东医科大学附属医院同位素室

出　　处：《中华核医学杂志》1995年第3期167-170,共4页Chinese Journal of Nuclear Medicine

摘　　要：对不同类型血液病外周性骨增的分布变化特点及规律进行了分析，并对其临床意义进行探讨．方法：用９９ｍＴｃ-硫胶体（３７０～５５０ＭＢｑ）对１３０例血液病患者进行全身骨髓显像；１９例在不同临床阶段重复显像随访；对１２例再生障碍性贫血及１０例缓解后白血病外周扩张增进行了穿刺细胞学检查．结果：外周髓扩张占受检者５８．５％，各类血液病外周髓扩张好发部位不完全相同．统计分析２０岁上、下年龄组外周髓扩张率差异无显著性．多数血液病外周髓扩张随病情好转有吸收趋势．穿刺发现在缓解后白血病的扩张髓内存在＂局灶性残余白血病＂．结论：不同血液病外周髓扩张形态有一定特点．了解外周髓扩张状态可为客观地判断骨髓造血储备能力提供依据，并有助于对部分血液病的诊断及疗效估计．显像检查是发现外周髓局灶性残余白血病必不可少的手段．PURPOSE We found previously that the changing patterns of bone marrow scintigraphy resulting from hematologic disorders were various. This study focused on discussing the imaging features and regularity of expanded peripheral bone marrow (PBM) in some blood diseases as well as their clinical usefulness. METHODS Bone marrow scintigraphy with 99mTc-sulfur colloid 370～550 MBq was performed in 130 cases with different types of blood diseases (irondeficiency anemia 17 cases, chronic hemolytic 13 cases, aplastic 41 cases; leukemia 37 cases, marrow dyshyperplasia syndrome 22 cases) and various stages of the disease (19 cases). The aspiration in PBM comparing with central bone marrow (CBM) was made in 12 aplastic anemia and 10 leukemia patients. RESULTS The expansion rate of PBM was 58.5% and the various blood diseases had different expansion regions. Repeated imaging showed that the expanded PBM tended to retract during clinical recovery. Aspiration from the expanding PBM defined more active hematopoiesisand higher count of leukemia blastic cells than that from iliac crest. The results indicated the presence of 'focal residual leukemia' (FRL) in PBM of complete remission leukemia patient. CONCLUSIONS The result of this study suggested that the expansion patterns of PBM in various hematologic disorders have definite features, which are helpful for the differential diagnosiS, valuable for evaluation of the reserved capability of active marrow and prognosis of the patients according to the further analysis of the PBM state. The bone marrow imaging is also an indispensable technique for finding FRL.

关 键 词：血液病 骨髓 放射性核素显像 

分 类 号：R552.04[医药卫生—血液循环系统疾病] R817.43[医药卫生—内科学]