Linden A, Zankovich R, Theissen P, Schauerte G, Diehl V, Schicha H
Institut für klinische und experimentelle Nuklearmedizin, Universität Köln, BRD.
Nuklearmedizin. 1989 Oct;28(5):166-71.
One hundred and seven patients with malignant Hodgkin and non-Hodgkin lymphoma were examined by bone marrow scintigraphy, MRI of bone marrow and bone marrow biopsy to detect bone marrow infiltration. The study included 2 patients where autopsy findings were subsequently available, 3 patients with blind rebiopsy and one patient with guided rebiopsy. The findings of bone marrow imaging and biopsy were classified as normal (grade 0), suggesting reactive changes of bone marrow (grade 1) or suspicious for infiltration (grade 2). About half of all results of biopsy and imaging methods agreed completely. There was a difference of two steps in the classification in only 2 cases (MRI) and 5 cases (scintigraphy). In patients with chronic lymphocytic leukemia false negative findings by both bone marrow imaging techniques were frequent. Unilateral blind bone marrow biopsy is usually accepted as the golden standard for the presence or absence of tumor infiltration. Although a positive biopsy result must be accepted as proof of bone marrow infiltration, our results indicate that a negative biopsy does not exclude tumor involvement. In all 4 patients with infiltration suspected on MRI or scintigraphy results but with normal findings or reactive changes in the first blind biopsy, blind rebiopsy or guided rebiopsy confirmed the results of the imaging methods. In both patients evaluated at autopsy the preceding MRI and scintigraphy results were confirmed completely, although in both of these patients antemortem biopsy had indicated different findings.(ABSTRACT TRUNCATED AT 250 WORDS)
对107例恶性霍奇金淋巴瘤和非霍奇金淋巴瘤患者进行了骨髓闪烁扫描、骨髓MRI及骨髓活检,以检测骨髓浸润情况。该研究纳入了2例随后有尸检结果的患者、3例进行了盲目重复活检的患者以及1例进行了引导性重复活检的患者。骨髓成像和活检结果分为正常(0级)、提示骨髓反应性改变(1级)或可疑浸润(2级)。活检和成像方法的所有结果中约有一半完全一致。仅在2例(MRI)和5例(闪烁扫描)中分类有两级差异。在慢性淋巴细胞白血病患者中,两种骨髓成像技术的假阴性结果很常见。单侧盲目骨髓活检通常被视为判断有无肿瘤浸润的金标准。虽然活检阳性结果必须被视为骨髓浸润的证据,但我们的结果表明,活检阴性并不能排除肿瘤累及。在所有4例MRI或闪烁扫描结果怀疑有浸润但首次盲目活检结果正常或为反应性改变的患者中,盲目重复活检或引导性重复活检证实了成像方法的结果。在2例接受尸检评估的患者中,先前的MRI和闪烁扫描结果均得到完全证实,尽管这2例患者生前活检显示的结果不同。(摘要截短于250字)