99Tcm-MIBI双时相平面显像阴性的散发性甲状旁腺癌一例及文献复习  

99Tcm-MIBI dual phase planar imaging negative in patient with sporadic parathyroid carcinoma:a case report and literature review

作　　者：杨冬竹 龙再颖 单英丽 李燕萍 Yang Dongzhu;Long Zaiying;Shan Yingli;Li Yanping(Department of Nuclear Medicine,Weihai Municipal Hospital,Weihai 064200,China)

机构地区：[1]威海市立医院核医学科,064200

出　　处：《国际放射医学核医学杂志》2020年第9期604-606,F0003,共4页International Journal of Radiation Medicine and Nuclear Medicine

摘　　要：笔者报道了一例散发性甲状旁腺癌(PTC)99Tcm-甲氧基异丁基异腈(MIBI)显像阴性病例。PTC患者临床上表现为严重高钙血症引起的多个系统及器官的改变,需依赖于超声、甲状旁腺核素扫描(99Tcm-MIBI)、CT等检查明确定位后予以手术治疗,其中99Tcm-MIBI显像具有方法简便、灵敏度高的优势,被广泛应用于临床,但仍有少数病例存在检查结果阴性的可能,易造成患者误诊、漏诊。笔者通过文献复习加深了对99Tcm-MIBI显像阴性的PTC患者的认识:对于怀疑PTC,但99Tcm-MIBI显像阴性的患者,需考虑到可能存在假阴性,并应分析讨论导致假阴性可能的原因,进而结合其他临床特征进行综合判断,尽可能地减少患者的误诊及漏诊。This paper reported a case of sporadic parathyroid carcinoma with negative 99Tcm-methoxyisobutylisonitrile(MIBI)imaging.The patient with parathyroid carcinoma is characterized by severe hypercalcemia which could cause pathological changes in multiple systems and different organs.It depends on ultrasound,parathyroid nuclide scan(99Tcm-MIBI)and CT examination to localize the position of lesions for further operation treatment.Among these examinations,parathyroid 99Tcm-MIBI imaging is widely used in clinical for its easy accessibility and high sensitivity.However,there are some cases presented with negative 99Tcm-MIBI imaging and is easy to be misdiagnosed.Through the literature review,the author deeply understood the negative 99Tcm-MIBI imaging of parathyroid carcinoma.For patients suspected of parathyroid carcinoma but with negative 99Tcm-MIBI imaging,the possibility of false negative need to be considered.In this specific clinical scenario,doctors should analyze its potential causes and make a comprehensive judgment through combining with other clinical characteristics,which could reduce the rate of misdiagnosis as much as possible.

关 键 词：甲状旁腺癌 核素扫描 甲氧基异丁基异腈 高钙血症 双时相 假阴性 综合判断 99Tcm 

分 类 号：R736.2[医药卫生—肿瘤] R730.44[医药卫生—临床医学]