[99m锝-硫胶体骨髓显像在再生障碍性贫血鉴别诊断中的价值]

[The value of 99mTc-sulfer colloid bone marrow scintigraphy in differential diagnosis of aplastic anemia].

作者信息

Liu Y, Jia F, Li M

机构信息

Shandong Medical University, Jinan 250012.

出版信息

Zhonghua Xue Ye Xue Za Zhi. 1999 Apr;20(4):180-2.

PMID:11601223

Abstract

OBJECTIVE

To diagnose equivocal aplastic anemia(AA) patients by the combination of clinical data and bone marrow scintigraphy.

METHODS

Bone marrow scintigraphy using 99mTc-sulfer colloid 370-550 MBq was analysed in 47 patients, including 28 cases of AA, 12 of myelodysplastic syndromes(10 MDS-RA and 2 MDS-RAEB) and 7 of AA-PNH syndrome.

RESULTS

Pancytopenia, hypercellular bone marrow associated with uneven disappearance of marrow image or focal hematopoiesis were found in 28 AA and 2 of 30 MDS-RA cases. Marrow imaging showed uneven low accumulation of radioactivity in 12 and focal patterns in 18 patients. Normal or high activity and expanded periphery of bone marrow was found in MDS patients (8 RA and 2 RAEB cases). Changes of activity and distribution of bone marrow during the transforming course were noticed in 4 AA-PNH syndrome patients.

CONCLUSIONS

Patch distribution and focal hemopoiesis is the outstanding features of AA marrow. The imaging features as well as expanded manner and increased activity of bone marrow are helpful to the differential diagnosis, evaluation of clinical status and explanation of marrow aspirate results.

摘要

目的

通过临床资料与骨髓闪烁显像相结合的方法诊断不典型再生障碍性贫血（AA）患者。

方法

对47例患者进行了使用99mTc - 硫化胶体370 - 550 MBq的骨髓闪烁显像分析，其中包括28例再生障碍性贫血患者、12例骨髓增生异常综合征患者（10例难治性贫血（MDS - RA）和2例难治性贫血伴原始细胞增多（MDS - RAEB））以及7例再生障碍性贫血 - 阵发性睡眠性血红蛋白尿综合征（AA - PNH）患者。

结果

28例再生障碍性贫血患者及30例MDS - RA患者中的2例出现全血细胞减少、骨髓细胞增多伴骨髓影像不均匀消失或局灶性造血。12例患者骨髓显像显示放射性不均匀低聚集，18例呈局灶性分布。MDS患者（8例RA和2例RAEB）骨髓活性正常或增高且外周扩大。4例AA - PNH综合征患者在转化过程中观察到骨髓活性和分布的变化。