18FFDG PET/CT和99TcmMDP骨扫描探测

多发性骨髓瘤骨破坏的对比研究

doi:10.3760/cma.j.issn.1673-422X.2013.12.019

摘要/Abstract

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FDG PET/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FDG PET/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，同时测量其最大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FDG PET/ CT发现227处（97%），骨扫描发现187处（80%），差异有统计学意义（χ2=32.43，P<0.05）；SUVmax为8.3±1.7（4.3～18.9）。18FFDG PET/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(χ2=78.09，P＜0.05)。结论18FFDG PET/CT对MM骨破坏病灶的探测优于99TcmMDP骨扫描。

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

Abstract: ObjectiveTo explore the application value of 18Ffluorodeoxyglucose positron emission tomography/computed tomography (18FFDG PET/CT) and 99Tcmmethylene diphosphonate (99TcmMDP) bone scintigraphy for detecting bone destruction in multiple myeloma (MM). Methods18FFDG PET/CT and 99TcmMDP bone scintigraphy results of 27 MM patients were analyzed retrospectively. Inspection areas checked by 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 results 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. ResultsA total of 235 lesions were found according to the reference standard. Of these, 227 lesions (97%) were identified by 18FFDG PET/CT, whereas 187 lesions (80%) were identified by bone scintigraphy, with a significant statistical difference (χ2=32.43, P＜0.05). SUVmax 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 (χ2=78.09, P＜0.05). Conclusion18FFDG PET/CT is a possible method to detect bone lesions in patients with MM, and is better than 99TcmMDP bone scintigraphy.

Key words: Multiple myeloma, Positronemission tomography, Tomography, emissioncomputed, singlephoton, Fluorodeoxyglucose F18, Technetium Tc 99m medronate

吴志兴, 吕宽, 张珂, 孔祥辉, 郭慧敏. 18FFDG PET/CT和99TcmMDP骨扫描探测多发性骨髓瘤骨破坏的对比研究[J]. 国际肿瘤学杂志, 2013, 40(12): 940-944.

WU Zhi-Xing, 吕Kuan , ZHANG Ke, KONG Xiang-Hui, GUO Hui-Min. Comparative study of 18FFDG PET/CT and 99TcmMDP bone scintigraphy in detecting multiple myeloma bone destruction[J]. Journal of International Oncology, 2013, 40(12): 940-944.

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