多发性骨髓瘤^(99)Tc^m-MIBI显像特点及临床价值  

Characteristics of ^(99)Tc^m-MIBI imaging in patients with multiple myeloma and its clinical value

作　　者：刘岱[1] 韩建奎[1] 王瑾[1] 吕学民[1] 杨付勇[1] 

机构地区：[1]山东大学齐鲁医院核医学科,济南250012

出　　处：《中华核医学杂志》2005年第4期216-218,共3页Chinese Journal of Nuclear Medicine

摘　　要：目的探讨多发性骨髓瘤(multiplemyeloma,MM)的99Tcm-甲氧基异丁基异腈(MIBI)显像特点及临床应用价值。方法注射99Tcm-MIBI555MBq后10min进行全身显像,根据图像特点分为4种表现类型:即N、D、F和F+D型,并依据显像范围(E)和程度(Ⅰ)对图像进行半定量计分及与临床血液学指标的相关分析。正常对照者12例,患者组42例。在随访中,对42例MM患者共进行了113人次的99Tcm-MIBI显像。结果不同临床分期、不同疾病状态的图像表现形式和半定量计分差异均有显著性。若以D、F、F+D型图像和综合计分≥2作为MM未完全缓解的判断标准,其诊断准确性为97.6%(80/82);而99Tcm-MIBI显像阴性(N型)或图像虽表现为D型,但综合计分≤2作为MM完全缓解的判断标准,其诊断准确性为100%(31/31)。图像半定量计分与血液中M蛋白含量及骨髓浆细胞数量呈正相关,与外周血血红蛋白含量呈负相关。结论99Tcm-MIBI显像能有效评估肿瘤负荷量及其活动程度。Objective To investigate the characteristics of ^99Tc^m-methoxyisobutylisonitrile （MIBI） imaging in patients with multiple myeloma （MM） and its clinical value. Methods Anterior and posterior whole-body imagings of 54 cases were obtained 10 min after intravenous injection of 555 MBq ^99Tc^m-MIBI. The images were classified as pattern N, D, F and F ＋ D, and were also graded semiquantitatively according to distribution extent （E） and intensity of uptake （I） of ^99Tc^m-MIBI in bone marrow, the bone marrow semi-quantitative scores and clinical hematological parameter correlated. Totally 12 normal controls and 42 MM patients were included. Results Statistics showed that the patterns and semi-quantitative scores of the imaging significantly differed among patients in different stages and different clinical status. If pattern D, F. F ＋ D and summed score ≥2 was considered as criteria for non-remission, the diagnostic accuracy of ^99Tc^m- MIBI imaging reached 97.6% （ 80/82 ）. If pattern N or D with a summed score ≤2 was considered as criteria for complete remission, then the diagnostic accuracy was 100% （31/31 ）. Moreover, significant positive correlation between the scores and both the percentage of bone marrow plasma cells and blood M protein were found, whereas a significant negative correlation was observed between the scores and peripheral blood hemoglobin levels. Conclusion ^99Tc^m-MIBI imaging is an effective and reliable method in evaluation of myeloma cell mass and clinical activity of disease and also plays a potential role in therapeutic monitoring.

关 键 词：多发性骨髓瘤 体层摄影术 发射型计算机 单光子 MIBI ^99TC^M-MIBI显像 显像特点 临床价值 ^99TC^M-甲氧基异丁基异腈 血红蛋白含量 图像特点 血液学指标 

分 类 号：R733.3[医药卫生—肿瘤]