The value of 99m Tc sulfer colloid bone marrow scintigraphy in differential diagnosis of aplastic anemia

Objective To diagnose equivocal aplastic anemia(AA) patients by the combination of clinical data and bone marrow scintigraphy.Methods Bone marrow scintigraphy using 99m Tc sulfer colloid 370～550MBq was analysed in 47 patients,including 28 cases of AA,12 of myelodysplastic syndromes(10 MDS RA and 2 MDS RAEB) and 7 of AA PNH syndrome.Results Pancytopenia,hypercellular bone marrow associated with uneven disappearance of marrow image or focal hematopoiesis were found in 28 AA and 2 of 30 MDS RA cases.Marrow imaging showed uneven low accumulation of radioactivity in 12 and focal patterns in 18 patients.Normal or high activity and expanded periphery of bone marrow was found in MDS patients (8 RA and 2 RAEB cases).Changes of activity and distribution of bone marrow during the transforming course were noticed in 4 AA PNH syndrome patients.Conclusions Patch distribution and focal hemopoiesis is the outstanding features of AA marrow.The imaging features as well as expanded manner and increased activity of bone marrow are helpful to the differential diagnosis, evaluation of clinical status and explanation of marrow aspirate results.