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目的 探讨用99Tcm 硫胶体显像观察骨髓增殖性疾病 (MPD)全身骨髓分布改变及特点的临床意义。方法 患者 85例 ,包括原发性骨髓纤维化 (IMF) 4 0例 ,真性红细胞增多症 (PV) 15例 ,原发性血小板增多症 (ET) 5例 ,慢性粒细胞性白血病 (CGL) 2 5例。99Tcm 硫胶体使用剂量 370～ 5 5 0MBq(2～ 5mL)。结果 全身骨髓分布异常占 88.2 % ,可见骨髓显像呈增强型、抑制型及抑制伴扩张型异常表现。中心性骨髓 (CBM)抑制率及外周性骨髓 (PBM)扩张率分别为 6 1.2 %及 5 6 .5 %。IMF骨髓抑制型较增强型外周血象降低程度差异有显著性 (P <0 .0 5 )。CGL患者CBM抑制及PBM扩张程度均随病情缓解而减轻。各疾病间PBM扩张形态有一定差异。结论 胶体骨髓显像的不同类型与MPD外周血象、临床病程及病情缓解状态有关 ;骨髓显像有助于MPD的鉴别诊断 ,了解MPD患者临床状态及预后
Objective To investigate the clinical significance of 99Tcm sulfur colloid imaging in the observation of the changes of bone marrow distribution and its characteristics in myeloproliferative diseases (MPD). Methods A total of 85 patients, including 40 cases of primary myelofibrosis (IMF), 15 cases of polycythemia vera (PV), 5 cases of essential thrombocythemia (ET), 5 cases of chronic myeloid leukemia 5 cases. 99Tcm sulfur colloid dosage 370 ~ 550MBq (2 ~ 5mL). Results The abnormal distribution of whole body bone marrow accounted for 88.2%. The bone marrow imaging showed enhanced, suppressed and suppressed with dilatation abnormalities. The rates of central bone marrow (CBM) inhibition and peripheral bone marrow (PBM) expansion were 6 1.2% and 56.5%, respectively. There was a significant difference in the degree of reduction of the myelosuppression-enhanced peripheral blood in the IMF (P <0.05). CBM inhibition of CBM and PBM expansion are alleviated with the severity of the disease. PBM expansion between the various forms of disease have some differences. Conclusions The different types of colloidal bone marrow imaging are related to the peripheral blood image, clinical course and the state of remission of MPD. Bone marrow imaging is helpful for the differential diagnosis of MPD and the clinical status and prognosis of MPD