三种影像学检查联用在继发性甲状旁腺功能亢进症术前定位的诊断价值研究  

Three combined imaging studies′ diagnostic value for preoperative position of hyperthyroidism

作　　者：宁玉东 王田田[1] 薄少军[1] 李洪跃[1] 杨晓琦[1] 张聪[1] 徐先发[1] 

机构地区：[1]北京大学民航临床医学院民航总医院耳鼻咽喉头颈外科,北京100123

出　　处：《临床耳鼻咽喉头颈外科杂志》2017年第18期1408-1411,共4页Journal of Clinical Otorhinolaryngology Head And Neck Surgery

摘　　要：目的:研究MRI、^(99m)锝-甲氧基异丁基异腈(^(99m)Tc-MIBI)核素显像及彩色多普勒超声等3种影像学联用在继发性甲状旁腺功能亢进症(SHPT)术前定位的诊断价值。方法:回顾性分析2010-2017年期间首次行甲状旁腺切除术的72例SHPT患者,72例患者均通过上述3种影像学对病变甲状旁腺进行术前定位。以手术后病理诊断结果为金标准,分别统计出3种影像学检查联用及各自所诊断甲状旁腺的确诊数及误诊数,并计算敏感度及特异度,通过SPSS 19.0软件运用率的χ~2检验将3种影像学检查联用同每种影像学方法的敏感度及特异度分别加以对比分析。结果:术后病理所报甲状旁腺共282枚,MRI、^(99m)Tc-MIBI核素显像、彩色多普勒超声及3种影像学检查联用的敏感度分别为72.70%、47.52%、44.33%、82.27%;特异度分别为78.16%、91.75%、95.14%、67.96%;3种影像学联用的敏感度大于各自的敏感度,均差异有统计学意义,而3种影像学联用的特异度均小于各自的特异度,差异有统计学意义。结论:MRI、^(99m)Tc-MIBI核素显像及彩色多普勒超声等3种影像学检查联用对病变甲状旁腺术前定位的诊断价值较高,可有效辅助SHPT的手术治疗。Objective：To investigatethe diagnostic value of three combined imaging studies′preoperative localization for secondary hyperparathyroidism.Method：This study lies on the retrospective analysis about 72 patients with secondary hyperparathyroidism who had parathyroid gland resection in our hospital from 2010 to 2017.All of 72 cases are examined by color doppler ultrasound,^（99m）TC-MIBI nuclide imaging and magnetic resonance imaging.According to the gold standard——pathological diagnosis after surgery,we compute the sensitivity and the specificity of various imaging examination and analyse these statistics by rate card square test with SPSS 19.0 software.Result：The parathyroid gland number of pathological diagnosis is 282.The sensitivities of magnetic resonance imaging,^（99m）TC-MIBI nuclide imaging,color doppler ultrasound and three combined imaging are 72.70%,47.52%,44.33% and 82.27%,respectively.The specificities of the examinations are 78.16%,91.75%,95.14% and 67.96%,respectively.The sensitivity of the combined three imaging studies is greater than the sensitivity of each single imaging studies,and there is a statistical significance between them.The specificity of the combined three imaging studies is smaller than the sensitivity of single imaging studies.There is a statistical significance,either.Conclusion：Three combined imaging studies′preoperative localization for secondary hyperparathyroidism has higher diagnostic value for the preoperative localization about secondary hyperparathyroidism.It can be a effective way to SHPT′s surgery.

关 键 词：甲状旁腺功能亢进症 核磁共振 彩色多普勒超声 ^99m锝-甲氧基异丁基异腈核素显像 

分 类 号：R582[医药卫生—内分泌] R445[医药卫生—内科学]