^99mTc-MIBI SPECT/CT与超声检查在继发性甲状旁腺功能亢进症术前定位中的应用  被引量:14

Application of^99mTc-MIBI SPECT/CT and ultrasonography in preoperative localization of secondary hyperparathyroidism

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作  者:李春红[1] 刘雪辉[1] 田洁[1] 庞毅[1] Li Chunhong;Liu Xuehui;Tian Jie;Pang Yi(Department of Cardiology,Tianjin Third Central Hospital,Tianjin 300170,China)

机构地区:[1]天津市第三中心医院心脏内科,300170

出  处:《国际生物医学工程杂志》2020年第4期304-308,共5页International Journal of Biomedical Engineering

摘  要:目的探讨超声联合使用甲氧基异丁基异腈(^99mTc-MIBI)放射性核素的单光子发射计算机断层成像术/计算机断层成像术(SPECT/CT)检查对继发性甲状旁腺功能亢进(SHPT)患者的甲状旁腺结节术前定位中的应用价值。方法对85例尿毒症继发甲状旁腺功能亢进,且行甲状旁腺全切术或甲状旁腺全切+自体移植术治疗的患者临床资料进行回顾性分析。所有患者均于术前行彩色多普勒超声及^99mTc-MIBI SPECT/CT检查。以手术病理结果为金标准,分析彩超检查、SPECT/CT检查及两者联合使用对甲状旁腺结节术前定位的意义。结果使用彩超和SPECT/CT检查对甲状旁腺结节的敏感性分别为70.9%、66.9%,差异无统计学意义(χ^2=2.773,P=0.428);二者联合应用对甲状旁腺结节的敏感性为91.3%,优于单独彩超检查(χ^2=5.161,P=0.023;)和SPECT/CT检查(χ^2=3.735,P=0.041)。对于异位甲状旁腺结节,SPECT/CT检查的效能明显优于彩超检查。结论对于需要进行甲状旁腺切除术的SHPT患者,术前联合应用超声检查和SPECT/CT可提高对甲状旁腺结节检测的敏感性及特异性,从而提高手术成功率。Objective To evaluate the value of^99mTc-MIBI SPECT/CT and ultrasonography in preoperative localization of secondary hyperpa-rathyroidism.Methods A retrospective analysis of 85 patients with secondary hyperparathyroidism due to uremia who underwent total parathyroidectomy or total parathyroidectomy+autologous transplantation was performed.All patients underwent color Doppler ultrasound and SPECT/CT before operation.Taking the surgical pathological results as the gold standard,the significance of SPECT/CT examination and color Doppler ultrasound examination for the preoperative localization of parathyroid nodules was analyzed.Results The sensitivity of color Doppler ultrasound and SPECT/CT for diagnosing ectopic parathyroid nodule were 70.9%and 66.9%,respectively,and the difference was not statistically significant(χ^2=2.773,P=0.428).The combined of color Doppler ultrasound and SPECT/CT was superior to the single application of color Doppler ultrasound(χ^2=5.161,P=0.023)and SPECT/CT(χ^2=3.735,P=0.041)for diagnosing ectopic parathyroid nodules.Conclusions For SHPT patients who require parathyroidectomy,the combined application of ultrasound and SPECT/CT before surgery can improve the sensitivity and specificity of the detection of parathyroid nodules,thereby increasing the success rate of surgery.

关 键 词:继发性甲状旁腺功能亢进 超声 ^99MTC-MIBI显像 

分 类 号:R653[医药卫生—外科学]

 

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