^(99m)Tc-MIBI双时相联合延迟断层显像在原发性甲状旁腺功能亢进术前定位诊断中的价值  

Preoperative localization diagnosis of primary hyperparathyroidism by using ^(99m)Tc-MIBI dual-phase combined with delayed tomography

作　　者：林天生[1] 王申[1] LIN Tian-sheng;WANG Shen(Department of Nuclear Medicine,Fujian Medical University Union Hospital,Fuzhou 350001,Fujian,China)

机构地区：[1]福建医科大学附属协和医院核医学科,福建福州350001

出　　处：《生物医学工程与临床》2019年第1期64-67,共4页Biomedical Engineering and Clinical Medicine

摘　　要：目的探讨^(99m)锝-甲氧基异丁基异腈(^(99m) Tc-MIBI)双时相联合延迟断层显像在原发性甲状旁腺功能亢进(PHPT)术前定位诊断价值。方法选择经病理确诊为PHPT患者62例,其中男性20例,女性42例;年龄21~68岁,平均年龄38.5岁。静脉注射^(99m) Tc-MIBI 370 MBq后行双时相显像,然后再行颈胸部断层显像;同期行颈部超声和计算机断层扫描(CT),所有影像诊断均与术后病理诊断进行比较,对3种检查结果进行分析。结果 ^(99m) Tc-MIBI双时相联合延迟断层显像诊断PHPT 58例,病灶检出率93.55%;其中1例甲状旁腺瘤内伴有囊性变和3例甲状旁腺增生^(99m) Tc-MIBI双时相联合延迟断层显像未被检出。颈部超声诊断PHPT 40例,病灶检出率为64.52%(40/62)。CT诊断PHPT 42例,病灶检出率为67.74%。超声和CT对3例异位甲状旁腺病灶未检出。^(99m) Tc-MIBI双时相联合延迟断层显像对病灶检出率高于超声和CT,与超声、CT相比,差异有统计学意义(χ~2=15.77、13.23,P <0.05)。超声对病灶检出率与CT比较,差异无统计学意义(χ~2=0.144,P> 0.05)。结论 ^(99m) Tc-MIBI双时相联合延迟断层显像在术前定位诊断中具有较高的临床价值。Objective To explore the value of99mTc-methoxyisobutyl isonitrile(99mTc-MIBI)dual phase combined with delayed tomography in preoperative localization diagnosis of primary hyperparathyroidism(PHPT).Methods A total of 62 patients with PHPT were enrolled,included 20 males and 42 females,aged 21-68 years old with mean of 38.5 years old.They were performed dual-phase imaging after intravenous99mTc-MIBI,and then were performed neck tomography imaging.Meanwhile,they were also examined by ultrasound and CT.All the images were compared with those of postoperative pathological diagnosis,and 3 kinds of imaging diagnosis results were analyzed.Results The99mTc-MIBI dual phase combined with delayed tomography showed PHPT in 58 cases with the diagnosis rate of 93.55%,meanwhile,there were 1 parathyroid adenomas patient with cystic changes and 3 misdiagnosed parathyroid hyperplasia.Forty cases of PHPT were detected by neck ultrasound,and the detection rate was 64.52%(40/62).CT confirmed 42 cases of PHPT with detection rate of 67.74%.The ultrasound and CT misdiagnosed 3 cases of ectopic parathyroid lesions.The detection rate of99mTc-MIBI dual-phase combined with delayed tomography was higher than that of ultrasound and CT,and the difference was statistically significant(χ^2=15.77,13.23,P<0.05).There was no significant difference in the detection rate of lesions between ultrasound and CT(χ^2=0.144,P>0.05).Conclusion It is demonstrated that99mTc-MIBI dual-phase combined with delayed tomography has high clinical value in preoperative localization of PHPT.

关 键 词：原发性甲状旁腺功能亢进 99m锝-甲氧基异丁基异腈(99mTC-MIBI) 单光子计算机发射断层显像 定位诊断 

分 类 号：R814.42[医药卫生—影像医学与核医学] R581.1[医药卫生—放射医学]