Wakasugi S, Teshima H, Nakamura H, Hashizume T, Maeda T, Hiraoka A, Hasegawa Y, Masaoka T
Department of Nuclear Medicine, Osaka Medical Center for Cancer and Cardiovascular Diseases, Japan.
Clin Nucl Med. 1998 Oct;23(10):664-71. doi: 10.1097/00003072-199810000-00004.
To determine the potential of Tc-99m MIBI for detecting bone marrow malignancy, MIBI imaging of the femur was evaluated. There was no detectable MIBI activity in 125 of 141 (89%) control patients. Clearly demonstrated focal or tubular MIBI activity indicating intramedullary accumulation was demonstrated in 44 of 45 (98%) patients with proven marrow malignancy: 9 patients with multiple myeloma, 10 patients with malignant lymphoma, 11 patients with acute leukemia, 1 patient with chronic leukemia, and 14 patients with skeletal metastases. No abnormal MIBI activity was observed in the femur in 19 of 22 (86%) patients who had no evidence of malignant involvement in the femoral marrow, in 3 patients with solitary plasmacytomas of the spine, sternum or iliac bone, or in 16 patients with malignant lymphoma. In 12 of 24 patients with acute leukemia in complete remission, no abnormal MIBI accumulation was shown in the femur, but in 12 patients, abnormal accumulation indicating residual leukemic activity was demonstrated. MIBI imaging correlated extremely well with MRI studies; 26 of 28 patients with focal or tubular increased MIBI activity in the femur showed decreased signal on T1-weighted images and a high signal on short inversion recovery images, and 11 patients with no abnormal activity showed a high signal on T1 images. MIBI imaging of the femoral bone marrow may be a new modality for detecting marrow malignancy.
为了确定锝-99m甲氧基异丁基异腈（Tc-99m MIBI）检测骨髓恶性肿瘤的潜力，对股骨进行了MIBI成像评估。141例对照患者中有125例（89%）未检测到MIBI活性。45例经证实患有骨髓恶性肿瘤的患者中有44例（98%）显示出明确的局灶性或管状MIBI活性，提示髓内积聚：9例多发性骨髓瘤患者、10例恶性淋巴瘤患者、11例急性白血病患者、1例慢性白血病患者和14例骨转移患者。22例股骨骨髓无恶性受累证据的患者中有19例（86%）、3例脊柱、胸骨或髂骨孤立性浆细胞瘤患者以及16例恶性淋巴瘤患者的股骨未观察到异常MIBI活性。24例完全缓解的急性白血病患者中有12例股骨未显示异常MIBI积聚，但有12例显示出提示残留白血病活性的异常积聚。MIBI成像与MRI研究相关性极佳；28例股骨MIBI活性局灶性或管状增加的患者中有26例在T1加权图像上信号降低，在短反转恢复图像上信号增高，11例无异常活性的患者在T1图像上信号增高。股骨骨髓的MIBI成像可能是检测骨髓恶性肿瘤的一种新方法。
