^(99m)Tc-MIBI显像甲状旁腺素在原发性甲状旁腺功能亢进中的应用  

Application of ^(99m)Tc-MIBI Parathyroid Imaging and Parathyroid Hormone for Primary Hyperparathyroidism

作　　者：毛荣虎[1] 刘保平[1] 韩星敏[1] 阮翘[1] 余娟[1] 蒋大治[1] 

机构地区：[1]郑州大学第一附属医院核医学科

出　　处：《医药论坛杂志》2007年第5期6-8,共3页Journal of Medical Forum

摘　　要：目的了解99mTc-MIBI显像在原发性甲状旁腺功能亢进症患者的诊断价值及与甲状旁腺素(PTH)放射免疫分析的关系。方法31例怀疑原发性甲状旁腺功能亢进症患者根据其后手术病理结果分为腺瘤组7例、增生组3例、正常组(经检查排除甲旁亢)21例,静脉注射370MBq(10mCi),99mTc-MIB行双时相采集,观察甲状旁腺病灶,显像前均进行了血清PTH放射免疫分析检测。结果腺瘤组7例中6例99mTc-MIBI显像阳性,增生组3例中2例99mTc-MIBI显像阳性,正常组无1例发现甲状旁腺病灶,根据病理结果显像发现腺瘤敏感性为85.7%,显像发现增生敏感性为66.7%,特异性为100%;99mTc-MIBI显像阳性患者的PTH:(251.91±113.56)ng/dl,99mTc-MIBI显像阴性患者的PTH:(35.37±29.78)ng/dl,两组P<0.05,有显著性差别;血清PTH水平≥100ng/dl(≥正常上限5倍)患者,MIBI敏感性88.9%,血清PTH水平≥200ng/dl,MIBI显像敏感性100%。结论99mTc-MIBI显像对原发性甲状旁腺功能亢进症的诊断敏感性高,尤其是腺瘤,其检测敏感性与高血清PTH水平相一致,类似于剂量依赖方式。Objective To evaluate the diagnostic value of ^99mTc - MIBI parathyroid imaging and the relation between ^99mTc -MIBI imaging and parathyroid hormone （PTH）in primary hyperparathyroidism. Methods 31 highly suspectable hyperparathyroidism patients were divided into 3 groups confirmed by pathology： 7 adenoma, 3 hyperplasia, 21 normal. And they underwent intravenous injection 370 MBq（10mCi） and double phase ^99mTc - MIBI imaging at neck and chest, before the imaging, they were detected the serum PTH by radioimmunoassay （RIA）. Results 6 patients were ^99mTc - MIBI positive in the adenomas group, 2 patients were ^99mTc MIBI positive in the hyperplasia group, the diagnostic of adenomas sensitivity reached 85.7% and hyperplasia reached 66.7%, specificity reached 100% ; The PTH level in the ^99mTc MIBI - positive patients was significantly greater than that in the negative patients （251.91 ± 113.56） ng/dl versus（35.37 ±29.78）ng/dl; P 〈0.05 ; 8 patients were ^99mTc - MIBI positive. When PTH levels exceeded 100 ng/dl, the sensitivity reached 88.9%. Conclusion There are significant clinical values of the diagnostic of hyperparathyroidism with ^99mTc - MIBI imaging, especially in the adenoma patients, and ^99mTc - MIBI parathyroid scintigraphy showed a good correlation with PTH level for parathyro glands on ^99mTc - MIBI parathyroid scinti id adenomas. Visualization of hyperfunctioning parath graphy was more likely with a higher serum PTH level dose - dependent manner.

关 键 词：MIBI 甲状旁腺素 甲状旁腺功能亢进 核素显像 

分 类 号：R582.1[医药卫生—内分泌]