一位70歲男性有胸悶和喘的症狀，由心臟內科醫師轉介至核醫科檢查。銘-201心肌血流造影顯示有 明顯的肺部攝取、左心室擴大、心肌下壁及下外側壁基底部有輕微持續的缺損，疑似爲橫膈膜衰減效 應，除此之外，原始影像發現在上胸部中線處有強烈的攝取病灶，單光子電腦斷層/電腦斷層顯示在胸 骨處有溶骨性腫瘤。經過一系列檢查後，最終確認爲IgA多發性骨髓瘤。仔細評估原始影像應爲所有心 肌血流硏究不可缺少的要素，因而重要的心外發現才不會被忽略。這個病例指出功能和結構性的融合 影像對於評估心外發現的重要性，有時患者症狀導因於此，也可能改變患者的治療處置。

A 70-year-old man with chest tightness and dyspnea was referred to our nuclear medicine department by his cardiologist. Thallium-201 myocardial perfusion scan disclosed marked lung uptake, left ventricular dilation, and mild persistent defect in basal portion of inferior and inferolateral walls, which scintigraphically favored the possibility of diaphragm attenuation. Additionally, focal hot uptake over midline of upper chest was noted on the cinematic raw data and SPECT/CT showed an expansile osteolytic tumor in sternal manubrium. After serial examinations, the diagnosis of IgA multiple myeloma was confirmed. A careful review of the cinematic raw data should be an integral part of the interpretation of all myocardial perfusion studies so that the important extracardiac findings are not inadvertently omitted. This case points the significance of ftinction-and-structure fused imaging in the evaluation of extracardiac findings, which may on occasion account for the patienfs symptoms or lead to an alteration in