X线骨骼摄片与核素骨显像在多发性骨髓瘤骨破坏的比较

目的 评价X线骨骼平片与放射性核素全身骨显像在多发性骨髓瘤(multiple myeloma，MM)患者骨损害的应用价值。方法 对20例初发MM患者X线骨骼平片和放射性核素(99MTC—MDP)全身骨显像对比研究。结果 X线骨骼平片穿凿样溶骨性骨破坏占90％(18／20例)，病理性骨折占80％(16／20例)，弥漫性骨质疏松占80％(16／20例)。放射性核素骨显像阳性率45％(9／20例)，其表现是放射性核素浓聚灶、稀疏区，分布不均。结论 放射性核素骨显像对MM骨损害检查不如x线骨骼平片敏感、特异性高。X线骨骼摄片检查仍是诊断MM骨骼损害的首选。

The skeletal radiography vs bone scintigraphy in assessment of bone destruction in patients with multiple myeloma: a comparative study

Objective To evaluate the radiography and bone scintigraphy for bone destruction in patients with multiple myeloma. Methods Skeletal radiographs and bone radionuclide images of 20 patients newly diagnosed as multiple myeloma were comparatively studied. Results On radiograph, lytic bone destruction was seen in 90% cases, pathological fracture was revealed in 80% cases, and diffuse osteoporosis was shown in 80% cases. While the positive rate of the bone scintigraphy was 45% . Areas of increased uptake and filling defects were revealed on scintigraphic images. Conclusion Radiography has higher sensitivity and specificity than radionuclide imaging in imaging bone destruction and pathological fracture in patients with multiple myeloma. Skeletal radiography is still the first choice of imaging modalities in assessing the bone destruction in patients with multiple myeloma.