99Tc^m-MIBI SPECT/CT显像及平面显像半定量分析对原发性甲状旁腺功能亢进症的诊断价值  

Diagnostic values of 99Tc^m-MIBI SPECT/CT imaging and planar imaging semi-quantitative analysis in primary hyperparathyroidism

作　　者：唐嘉励[1,2] 段东 张辉[1,3] Tang Jiali;Duan Dong;Zhang Hui(Department of Nuclear Medicine,the First Affiliated Hospital of Chongqing Medical University,Chongqing 400016,China;Department of Nuclear Medicine,Zigong First People’s Hospital,Zigong 643000,China;Department of Nuclear Medicine,Neijiang Second People’s Hospital,Neijiang 641000,China)

机构地区：[1]重庆医科大学附属第一医院核医学科,400016 [2]自贡市第一人民医院核医学科,643000 [3]内江市第二人名医院核医学科,641000

出　　处：《中华内分泌外科杂志》2019年第1期17-21,共5页Chinese Journal of Endocrine Surgery

基　　金：重庆市科技计划项目(csct2014jcyjA10012).

摘　　要：目的探讨99Tc^m-MIBISPECT/CT融合显像及99Tc^m-MIBI平面显像半定量分析对原发性甲状旁腺功能亢进症(primary hyperparathyroidism,PHPT)的诊断价值。方法回顾性分析2014年6月至2016年12月期间重庆医科大学附属第一医院内分泌科及甲乳外科怀疑PHPT的89例临床资料。以术后病检及随访结果为评价标准,比较SPECT/CT融合显像、99Tc^m-MIBI平面显像、B超的诊断效能。对99Tc^m-MIBI平面显像采用计算机感兴趣区技术测量并计算病灶与正常组织的摄取比值(T/NT),对不同病理类型患者的血清PTH及T/NT比值进行相关性分析。结果SPECT/CT融合显像、99Tc^m-MIBI平面显像、B超诊断PHPT的灵敏度分别为98.08%、88.46%、78.43%,特异度分别为82.93%、82.93%、58.82%;病理类型分别与PTH浓度、早期相及延迟相T/NT比值呈正相关(相关系数r分别为0.741、0.642、0.729)。结论99Tc^m-MIBISPECT/CT融合显像对PHPT的术前诊断价值优于99Tc^m-MIBI平面显像及B超,平面显像的半定量分析也为PHPT的鉴别诊断提供了新思路。Objective To evaluate the diagnostic value of 99Tc^m-MIBI SPECT/CT imaging and 99Tc^m-MIBI planar imaging semi-quantitative analysis in primary hyperparathyroidism(PHPT).Methods A total of 89 patients were enrolled into this retrospective study.The diagnostic efficiencies of 99Tc^m-MIBI SPECT/CT were compared with 99Tc^m-MIBI planar scintigraphy and ultrasound,while the surgical pathology and the clinical follow-up results were considered as the standard.The region of interest extraction technique was used to measure and calculate the tumour to normal tissue ratios(T/NT)in the early and delayed phase of the planar scintigraphy,and the correlation between pathological type,PTH concentration and T/NT ratios was analyzed.Results The sensitivities and specificities of SPECT/CT,99Tc^m-MIBI planar scintigraphy and ultrasound were 98.08%,88.46%,78.43%;82.93%,82.93%,58.82% respectively.There were statistically significant correlations between the pathological type and PTH concentration,early phase T/NT and delayed phase T/NT,and the correlation coefficients r were 0.741,0.642 and 0.729,respectively.Conclusions 99Tc^m-MIBI SPECT/CT imaging is an effective method for diagnosis of PHPT,with higher clinical application value than 99Tc^m-MIBI planar scintigraphy and ultrasound.The semi-quantitative analysis of 99Tc^m-MIBI planar scintigraphy provides a new method for the differential diagnosis of PHPT.

关 键 词：甲状旁腺功能亢进症 原发性 99m锝-甲氧基异丁基异腈 单光子发射型计算机断层显像 计算机断层扫描 

分 类 号：R582.1[医药卫生—内分泌] R817.4[医药卫生—内科学]