18F-FDGPET／CT和99Tcm-MDP骨扫描探测多发性骨髓瘤骨破坏的对比研究  

Comparative study of 18F-FDG PET/CT and 99Tcm-MDP bone scintigraphy in detecting multiple myeloma bone destruction

作　　者：吴志兴[1] 吕宽[1] 张珂[1] 孔祥辉[1] 郭慧敏[1] 

机构地区：[1]山东大学附属省立医院核医学科,济南250021

出　　处：《国际肿瘤学杂志》2013年第12期940-944,共5页Journal of International Oncology

摘　　要：目的探讨18F-氟脱氧葡萄糖正电子发射断层显像／计算机断层摄影术（18F-FDGPET／CT）和99Tcm-亚甲基二磷酸盐（99Tcm-MDP）骨扫描在探测多发性骨髓瘤（MM）骨破坏方面的应用价值。方法回顾性分析经临床确诊的MM患者27例，全部行18F—FDGPET／CT和99Tcm-MDP骨扫描，以X线片和磁共振成像（MRI）检查部位为限定范围，分别记录病灶骨质破坏的部位和数量，同肘测量其最大SUV值（SUVmax），并将二者探测结果进行对比分析。诊断标准综合MRI和x线片结果判定。结果综合MRI和x线片发现病灶共235处，其中18F-FDGPET／CT发现227处（97％），骨扫描发现187处（80％），差异有统计学意义（矿=32．43，P〈0．05）；SUVmax为8．3±1．7（4．3～18．9）。18F—FDGPET／CT和骨扫描的骨折发现率分别为100％（97／97）和90％（87／97），差异有统计学意义（x2=78．09，P〈0．05）。结论18F—FDGPET／CT对MM骨破坏病灶的探测优于”TcnlMDP骨扫描。Objective To explore the application value of 18F-fluorodeoxyglucose positron emission tomography/eomputed tomography （18F-FDG PET/CT） and 99Tcm-methylene diphosphonate （99 Tcm-MDP） bone scintigraphy for detecting bone destruction in multiple myeloma （MM）. Methods 18 F-FDG PET/CT and 99Tcm-MDP bone scintigraphy results of 27 MM patients were analyzed retrospectively. Inspection areas checked hy magnetic resonance imaging （MRI） and X-ray were the limited scopes. The location and number of bone destruction were recorded, and the maximal standardized uptake value （SUVmax ） was measured simultaneously.The resuhs were comparatively analyzed. Diagnostic certainty regarding the presence or absence of bone destruction was evaluated according to the reference standard consisting of MRI and X-ray. Results A total of 235 lesions were found according to the reference standard. Of these, 227 lesions （97%） were identified by is F-FDG PET/CT, whereas 187 lesions （80%） were identified by bone scintigraphy, with a significant statisti- cal difference （X2 = 32.43, P 〈 0.05 ）. SUVm= was 8.3 ± 1.7 （4.3 to 18.9 ）. The discovery rates of bone fracture of 18F-FDG PET/CT and bone scintigraphy were 100% （97/97） and 90% （87/97）, and there was a significant statistical difference between them （X2 = 78.09, P 〈 0.05 ）. Conclusion 18F-FDG PET/CT is a possible method to detect bone lesions in patients with MM, and is better than 99Tcm-MDP bone scintigraphy.

关 键 词：多发性骨髓瘤 正电子发射断层显像术 体层摄影术 发射型计算机 单光子 氟脱氧 葡萄糖F18 99M锝美罗酸盐 

分 类 号：R738.1[医药卫生—肿瘤]