SPECT/CT对继发性甲状旁腺功能亢进症甲状旁腺腺体定位诊断的应用价值分析  

The value of SPECT/CT in diagnosing parathyroid in patients with secondary hyperparathyroidism

作　　者：袁孝军[1,2] 李永军[2] 徐兆强[2] 

机构地区：[1]江苏省级机关医院医学影像科,江苏南京210024 [2]南京医科大学第一附属医院核医学科,江苏南京210029

出　　处：《南京医科大学学报（自然科学版）》2013年第10期1474-1477,共4页Journal of Nanjing Medical University(Natural Sciences)

摘　　要：目的 :分析SPECT/CT同机断层融合显像对继发性甲状旁腺功能亢进症(SHPT)甲状旁腺腺体定位诊断的应用价值。方法:35例SHPT患者常规行99mTc-甲氧基异丁基异腈(99mTc-MIBI)-双时相平面显像(MIBI平面),共出现46处甲状腺床外的异常放射性摄取灶,对颈部及床外异常摄取灶行SPECT/CT同机断层融合显像,根据手术病理结果比较MIBI平面、SPECT/CT对甲状腺床位置甲状旁腺(常位甲状旁腺)与异位甲状旁腺在敏感性及假阳性方面的差别。结果:MIBI平面及SPECT/CT对常位甲状旁腺敏感性相似(63.9%vs 67.0%,P>0.05),SPECT/CT的假阳性百分比低于MIBI平面(3.0%vs 18.4%,P<0.05),MIBI平面及SPECT/CT对异位甲状旁腺敏感性均为92.5%,SPECT/CT对异位甲状旁腺的假阳性百分比低于MIBI平面(2.6%vs 19.6%,P<0.05),SPECT/CT对异位甲状旁腺敏感性明显高于常位甲状旁腺(92.5%vs 67.0%,P<0.05)。结论:SPECT/CT检查不能明显提高对甲状旁腺腺体定位诊断的敏感性,但明显减少假阳性,尤其对异位甲状旁腺有更高的临床应用价值。Objective：To analysis the value of single-photon emission tomography/computed tomography （SPECT/CT） in diagnosing parathyroid in patients with hyperparathyroidism. Methods：Thirty-five patients with secondary hyperparathyroidism （SHPT） were performed 99mTc-methoxyisobutylisonitrile （99mTc-MIBI） dual-phase planar scintigraphy （MIBI planar）,and 46 focis outside of thyroid-bed were observed. SPECT/CT imaging including neck and additional radical uptake was added in them. The difference in sensitivity and false positive percent （FPP） between MIBI planar and SPECT/CT in finding the normalsite parathyroid and ectopic parathyroid were compared according to the pathology. Results：The sensitivity of MIBI planar in finding the normalsite parathyroid was similar to SPECT/CT（63.9% vs 67.0% ,P 〉 0.05） ,the FPP was significantly lower than SPECT/CT（3.0% vs 18.4%, P 〈0.05）. The sensitivity of MIBI planar in finding the ectopic parathyroid was similar to SPECT/CT （either 92.5%）,the FPP was significantly lower than SPECT/CT（2.6% vs 19.6%,P 〈 0.05）. The sensitivity of SPECT/CT in finding the ectopic parathyroid was significantly higher than itself in finding the normalsite parathyroid （92.5% vs 67.0%,P 〈 0.05）. Conclusion：SPECT/CT can not add the sensitivity in finding parathyroid,but can significantly reduce FPP. It is very valuable in clinical work,especially in finding the ectopic parathyroid.

关 键 词：继发性甲状旁腺功能亢进症 放射性核素显像 体层摄影术 发射型计算机 融合显像 

分 类 号：R445.6[医药卫生—影像医学与核医学]