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Objective To evaluate the clinical value of the qualitative and semi-quantitative analysis of technetium-99m labeled sulfur colloid bone marrow imaging for the diagnosis of the children Aplastic anemia.Methods Seventy-seven children, including for 65 clinical diagnosis aplastic anemia patients and 12 not hematologic disease patients whose peripheral blood and bone marrow is normal, were studied. Whole-body bone marrow imaging was performed 1 to 2 hours after intravenous injection of 185-370 MBq Tc-99m sulfur colloid, using a Single-photon Emission Computer Tomography(SPECT). After imaging, the qualitative and semi-quantitative analysis by ROI(region of interest) were performed, and the sensitivity、specificity and accuracy were obtained, respectively. All scintigraphy results were compared with bone marrow puncture and (or) biopsy.20 cases of aplastic anemia diagnosed in children were studies with sulfur colloid bone marrow imaging, before and after remission, respectively, for analysis and evaluation of the change before and after treatment.Results The ratio of the multifocal hyperplasia is 69.2%(45/65). Type I is 14 cases and type II is 31. Type V is 6cases. The true positive of the qualitative analysis is 59, the false negative is 6 and the true negative is 12. The semi-quantitative method’s true positive, the false negative, the false negative,the true negative is 63,1,2,11. To normal children, their bone marrow volume of the total, the skull, sternum, lumar spine, pelvis, sacroiliac joints, upper and lower limbs are 11.98±5.08,12.58±5.19,. 19.21±10.49,23.55±6.81,19.05±5.43,24.75±5.71,10.2±4.43,13.88±9.22, respectively.To aplastic anemia children, the semi-quantitative of bone marrow value are,13.38±7.76,12.13±6.68,15.51±7.58,13.93±6.74,18.21±8.86.8.37±4.12,6.04±3.68, respectively. All of them are significantly different (t=3.23、3.69、3.18、3.55、2.05、3.56、8.22, P<0.05).To the 20 cases, In the differentiating prophase; from anaphase remission results, the total bone marrow, central bone marrow, peripheral bone marrow volume is no significant difference (t=0.71、0.91、1.02, P均>0.05); while sacroiliac joints and pelvic bone volume is significantly different (t=3.71, P<0.05) Conclusion The specificity of the qualitative analysis is high,.While the positive rate and sensitivity of the semi-quantitative analysis is higher. The semi-quantitative analysis of bone marrow imaging is helpful to diagnosis and differential diagnosis of the AA. Combined with the twe methods, it’s useful to diagnosis or treatment of aplastic anemia and evaluating to curative effect and to monitor bone marrow damage after chemotherapy.
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