^(99m)Tc-MIBI双时相SPECT/CT对甲状旁腺功能亢进症的诊断价值  

Diagnostic Value of Dual Phase ^(99m)Tc-Sestamibi SPECT/CT in Hyperparathyroidism

作　　者：李文婵[1] 姚稚明[1] 刘秀芹[1] Li Wenchan;Yao Zhiming;Liu Xiuqin(Department of Nuclear Medicine,Beijing Hospital,Beijing 100730,China)

机构地区：[1]北京医院核医学科,100730

出　　处：《医学研究杂志》2018年第7期126-128,140,共4页Journal of Medical Research

摘　　要：目的评价99mTc-MIBI双时相平面显像及SPECT/CT对甲状旁腺功能亢进症(hyperparathyroidism,HPT)的术前诊断价值,比较原发性HPT(PHPT)与继发性HPT(SHPT)的诊断效能差异。方法回顾性分析2012~2017年因甲状旁腺激素水平升高行99mTc-MIBI双时相平面及SPECT/CT的住院患者资料,以术后病理为金标准,比较平面及SPECT/CT、PHPT与SHPT的诊断效能差异。结果 80例HPT患者中23例于笔者医院行手术治疗,术中共发现37个HPT病灶(腺瘤19个,增生16个,腺癌2个),平面显像和SPECT/CT分别检出28和31个病灶,敏感度分别为75.7%和83.8%。16例PHPT共18个病灶,平面显像和SPECT/CT均检出17个病灶,敏感度均为94.4%;7例SHPT共19个病灶,平面显像和SPECT/CT分别检出11和14个病灶,敏感度分别为57.9%和73.7%。19个腺瘤和2个腺癌中,平面显像和SPECT/CT均全部检出,敏感度均为100%;16个增生病灶中,平面显像和SPECT/CT分别检出7和10个,敏感度分别为43.8%和62.5%。结论99mTc-MIBI双时相显像在PHPT患者中,平面显像和SPECT/CT具有相同的诊断敏感度,但是在SHPT患者中,SPECT/CT诊断效能高于平面显像,SPECT/CT对于甲状旁腺增生的诊断效能高于平面显像,二者在甲状旁腺腺瘤的诊断效能上相近。Objective To evaluate diagnostic value of dual phase 99mTc - sestamibi planar imaging and SPECT/CT in hyperparathy- roidism （HPT） and compare their difference in primary hyperparathyroidism （PHPT） and secondary hyperparathyroidism （SHPT）. Meth- ods We retrospectively reviewed the clinical data of our in - patients who underwent dual phase 99mTc - sestamibi planar imaging and SPECT/CT because of elevated parathyroid hormone level from 2012 to 2017. Final operation results and pathology served as gold stand- ard. We compared diagnosis performance in planar imaging and SPECT/CT, and also compare diagnosis difference in PHPT and SHPT patients. Results Twenty - three patients of 80 patients underwent parathyroidectomy in our hospital and 37 HPT lesions （ 19 adenoma, 16 hyperplasia and 2 adenocarcinoma） were found during surgeries. Planar imaging and SPECT/CT found 28 and 31 lesions respectively and sensitivity were 75.7% and 83.8% respectively. In 18 lesions of 16 PHPT patients, both planar imaging and SPECT/CT found 17 le- sions and sensitivity was 94.4%. In 19 lesions of 7 SHPT patients, planar imaging and SPECT/CT found 11 and 14 lesions respectively and sensitivity were 57.9% and 73.7% respectively. Nineteen adenoma and 2 adenocarcinoma were all found by both planar imaging and SPECT/CT and sensitivity was 100% . In 16 hyperplasia, Planar imaging and SPECT/CT found 7 and 10 lesions respectively and sensitivi- ty were 43. 8% and 62. 5% respectively. Conclusion The sensitivity of dual phase 99mTc - sestamibi planar imaging was same as SPECT/CT in PHPT patients. But in SHPT patients, SPECT/CT showed higher sensitivity than planar imaging. The sensitivity of planar imaging was same as SPECT/CT in detecting parathyroid adenoma. But in parathyroid hyperplasia, SPECT/CT showed higher sensitivity than planar imaging.

关 键 词：甲状旁腺功能亢进症 单光子发射型计算机体层摄影术 X线计算机体层摄影术 99M锝甲氧基异丁基异腈 

分 类 号：R4[医药卫生—临床医学]