摘要目的 对比研究18F-FDG PET/CT和99Tcm-亚甲基二膦酸盐(99Tcm-MDP)SPECT全身骨显像对多发性骨髓瘤骨病(MBD)的诊断价值.方法 回顾性分析2015年4月至2018年5月在安徽医科大学附属安庆医院经临床确诊的29例多发性骨髓瘤初治患者,其中,男性18例、女性11例,年龄39～81(60.14±10.41)岁.所有患者均于两周内先后行18F-FDG PET/CT显像及99Tcm-MDP SPECT全身骨显像,对比分析18F-FDG PET/CT和99Tcm-MDP SPECT显像检出的骨异常改变,对两种显像方法检出MBD例数的比较采用配对资料的χ2检验.结果 29例多发性骨髓瘤患者均伴发MBD,18F-FDG PET/CT显像阳性者28例(骨骼局灶型摄取显像剂18例,弥漫型骨髓摄取1例,混合型摄取9例),99Tcm-MDP SPECT骨显像阳性21例(表现为骨骼单发或多发放射性浓聚灶),阳性符合率分别为96.6％(28/29)和72.4％(21/29),差异有统计学意义(χ2=5.0,P<0.05).结论 18F-FDG PET/CT显像比99Tcm-MDP SPECT全身骨显像对MBD的探测更为灵敏,且对骨髓浸润及髓外侵犯亦具有良好的诊断效能.

abstractsObjiective To compare the diagnostic value of 18F-fluorodeoxyglucose (FDG) PET/CT and99Tcm-methylene diphosphonic acid (99Tcm-MDP) SPECT whole body bone scan in detecting of multiple myeloma bone disease (MBD).Methods The retrospective study enrolled 18 male and 11 female multipe myeloma (MM) patients, aged 39-81 years (mean, 60.14±10.41 years) and clinically diagnosed from April 2015 to May 2018 in Anqing hospital affiliated to Anhui medical university.18F-FDG PET/CT and 99Tcm-MDP SPECT were performed two weeks apart, and χ2 test was used in comparing abnormal bone changes detected by 18F-FDG PET/CT and 99Tcm-MDP SPECT. Results 18F-FDG PET/CT and 99Tcm-MDP SPECT accurately diagnosed 28 and 21 MM patients, respectively. Eighteen patients were focal, one patient was diffuse, and nine patients were mixed on the 18F-FDG PET/CT images. Twenty-one MM patients were found single, that is, multiple bones accumulated the agent abnormally on 99Tcm-MDP SPECT images. The positive match rate of 18F-FDG PET/CT and 99Tcm-MDP SPECT were 96.6％ (28/29) and 72.4％ (21/29), respectively. The differences between the sensitivities of the two methods were significant.Conclusion The results indicate that 18F-FDG PET/CT is more sensitive than 99Tcm-MDP SPECT in detecting MBD in patients with MM and has a significant diagnostic value for bone marrow involvement and extramedullary disease.