The authors compare the importance of scintigraphic examination bymeans of 99mTc-MIBI and MR for the examination of spine and pelvis in multiple myeloma (MM). A total of 39 patients were examined with three weeks at a maximum, on the average during 10 days by both methods. The demonstration of pathological changes in new forms of the disease was virtually the same in both methods; there was a complete agreement in monoclonal gammapathies of undetermined significance – negative results in all cases. The advantage of scintigraphy is in the examination of the whole body and examination of extramedullar lesions, but its disadvantage lays in the fact that it cannot disclose epidural propagation of MM and compression of vertebrae. On the other hand it is faster in the diagnosis of remission of the disease, since pathological changes last for longer period of time when examined by MR. It is difficult to compare the proportion of focal and diffusion changes in individual methods, since scintigraphy cannot disclose foci smaller than 10 mm. The authors are of the opinion that the diagnostic algorithm should first employ scintigraphy for introductory examination and apply MR according to the scintigraphy results – obviously with the exception of cases, where compression in the spine canal is suspected.

        Key words: multiple myeloma – 99mTc-MIBI scintigraphy – magnetic resonance