SPECT全身骨显像对多发性骨髓瘤和前列腺癌骨转移瘤的鉴别诊断价值

目的:探究多发性骨髓瘤和前列腺癌在单光子发射计算机断层成像术(SPECT)骨显像上的区别与联系.方法:对2013年6月至2015年12月收治的SPECT图像表现为全身广泛骨质代谢活跃灶的多发性骨髓瘤和前列腺癌患者进行回顾性研究,分析两者病灶部位、数目、形态以及各自典型影像表现.结果:25例多发性骨髓瘤患者共检出327个病灶,病灶最常累及部位分别为肋骨、脊柱、骨盆、颅骨、肩关节和股骨;33例前列腺癌患者共检出851个病灶,转移病灶最常累及部位分别为脊柱、肋骨、骨盆、股骨和肩关节、胸骨、颅骨、肱骨.多发性骨髓瘤在图像上表现为多发点状或类圆形浓聚,颅骨"帽状"浓集、肋骨"串珠样"浓集是其特征性表现;前列腺癌骨显像表现为放射性核素异常浓聚,大小、形态不一,多为点状、条状、片状或不规则浓集灶,全身骨骼"超级影像"为其特征性表现.结论:SPECT骨显像对多发性骨髓瘤和前列腺癌骨转移瘤有一定的鉴别诊断价值.

The value of SPECT whole - body bone imaging in differential diagnosis of multiple mye-loma and bone metastatic tumors of prostate cancer

Objective:To explore the relations and differences of multiple myeloma and prostate cancer in SPECT whole body bone imaging. Methods:Patients with multiple myeloma or prostate cancer presenting with mutiple metab-olism active focus of whole - body bone imaging in our hospital from June 2013 to December 2015 were retrospectively reviewed. The performance of multiple myeloma and prostate cancer whole - body bone imaging in lesion site,the number,shape and their typical imaging were analyzed. Results:327 bone lesions were detected in 25 multiple myelo-ma patients,multiple myeloma bone lesions most commonly exist on ribs,spine,pelvis,skull,shoulder,femur;851 le-sions were detected in 33 prostate cancer patients,the most common metastasis sites included spine,ribs,pelvis,femur and shoulder,sternum,skull,humerus. Multiple myeloma bone imaging showed multiple spots or oval uptake. " Cap -like" on skull and " beaded" concentration on ribs were its characteristic features;Prostate cancer bone imaging showed abnormal radionuclide uptake which differed in size and shape,such as punctate,strip,sheet or irregular con-centration. " Super imaging " in whole - body bone imaging was its characteristic feature. Conclusion:SPECT bone imaging was valuable to distinguish multiple myeloma and prostate cancer.