Nilsson-Ehle H, Holmdahl C, Suurküla M, Westin J
Acta Med Scand. 1982;211(6):427-32. doi: 10.1111/j.0954-6820.1982.tb01976.x.
The contribution of bone scintigraphy to the diagnosis of skeletal involvement in multiple myeloma was evaluated in a consecutive, unselected series of 25 previously untreated patients. Definite scintigraphic abnormalities were found in 11 patients (localized in 4, generalized in 7) (44%). In the majority of patients the clinical value of the information gained from scintigraphy was roughly equal to that found by radiography. However, 2 patients with normal and 2 with questionable bone scans had X-ray evidence of skeletal involvement, and the extent of bone destruction in 4 cases was seriously underestimated in the bone scans. Small osteolytic lesions were as a rule not detected by scintigraphy. On the other hand, in 8 patients the bone scan added information of involvement of ribs, pelvis and vertebrae, not clearly visualized by X-ray. In 2 patients, both with IgA myeloma, hypercalcemia and uremia, a massive extraskeletal uptake of the bone-seeking isotope was observed. Autopsy verified in one case the presence of a disseminated metastatic calcification.
在连续选取的25例未经治疗的患者中，评估了骨闪烁扫描对多发性骨髓瘤骨骼受累诊断的贡献。11例患者发现明确的闪烁扫描异常（4例为局限性，7例为全身性）（44%）。在大多数患者中，从闪烁扫描获得的信息的临床价值与X线摄影大致相当。然而，2例骨扫描正常和2例骨扫描结果存疑的患者有骨骼受累的X线证据，且4例患者骨扫描严重低估了骨质破坏程度。骨闪烁扫描通常检测不到小的溶骨性病变。另一方面，8例患者的骨扫描提供了肋骨、骨盆和脊椎受累的信息，而X线未清晰显示这些部位。2例均为IgA型骨髓瘤、高钙血症和尿毒症的患者，观察到大量亲骨性同位素的骨骼外摄取。尸检在1例中证实存在弥漫性转移性钙化。
