PET／CT对多发性骨髓瘤的诊断价值  

The staging value with PET/CT imaging in multiple myeloma

作　　者：姚树展[1] 孟繁禄[1] 刘松涛[1] 李昕[1] 李军[1] 李广义[1] 宁国庆[1] 

机构地区：[1]山东大学附属省立医院PET/CT中心,济南250021

出　　处：《中华核医学杂志》2009年第2期82-84,共3页Chinese Journal of Nuclear Medicine

摘　　要：目的探讨多发性骨髓瘤的PET／CT影像学特点，评价其在多发性骨髓瘤诊断中的价值。方法15例按2001年WHO诊断标准确诊为多发性骨髓瘤患者，均在治疗前行PET／CT显像。15例患者经骨髓穿刺和（或）手术病理检查测浆细胞，实验室检查显示有9例患者血清IgG明显升高（〉35g／L），有8例24h尿本周蛋白增高（〉1g），15例患者均有溶骨性病变。结果CT所示骨质破坏区域及PET示代谢变化骨髓瘤病灶137个。多发性骨髓瘤病变部位以颅骨37．2％（51／137）、肋骨26．3％（36／137）、椎体12．4％（17／137）为多发，其次为髂骨7．3％（10／137）、骶骨5．8％（8／137）、四肢骨4．4％（6／137）、锁骨3．6％（5／137）、肩胛骨2．9％（4／137）。在137个病灶中，有71个病灶PET显示放射性摄取增高，阳性率为51．8％；有66个病灶表现为放射性摄取稀疏及缺损。而CT主要表现为多发性穿凿样或虫蚀样骨质破坏。结论PET／CT显像对多发性骨髓瘤的临床诊断有较高的价值。Objective The characteristic of PET/CT imaging in patients with multiple myeloma （MM） were investigated. The aim of this study was to assess the adequacy of PET/CT in staging of MM patients. Methods Fifteen newly diagnosed patients with MM underwent 18^F-fluorodeoxyglucose （FDG） PET/CT examination before treatment. Plasma cell pathology was confirmed by bone marrow biopsy and （or） excisonal histopathology. Quantification test of monoclonal gammopathic protein （ IgG 〉 35 g/L） was elevated in 9 cases, and 24 h urine Bence-Jones protein was positive in 8 cases （ 〉 1 g）. Osteolytic bone lesions were shown on CT scan in all patients and clinical diagnosis was established according to the standard of WHO （2001）. Results A total 137 lesions were detected on PET/CT study. Among them, 51 lesions was located in skull （37.2%）, 36 in rib （26. 3%）, 17 in centrum （12.4%）, 10 in ilium （7. 3% ）, 8 in sacrum （5.8%）, 6 in limbs （4.4%）, 5 in clavicle （3.6%） and 4 in scapula （2.9%）. According to PET/CT results, high 18^F-FDG uptake was found in 71 lesions with positive detection rate of 51.8% （71/137）, whereas other 66 lesions with low or hypometabolic 18^F-FDG uptake. On CT imaging, typical findings were multiple lytic bone destructions and numerous punched-out defected without surrounding sclerosis. Conclusion PET/CT imaging may be useful in MM staging.

关 键 词：多发性骨髓瘤 体层摄影术 发射型计算机 体层摄影术 X线计算机 脱氧葡萄糖 

分 类 号：R686[医药卫生—骨科学]