^(99)Tc^(m)-MIBI双时相显像对甲状旁腺腺瘤和甲状旁腺增生的诊断价值  

Diagnostic value of ^(99)Tc^(m)-MIBI dual-time imaging for parathyroid adenoma and parathyroid hyperplasia

作　　者：刘岩[1] 王岐 杨路路 梁一倩 杨爱民[1] 许薇 薛建军[1] LIU Yan;WANG Qi;YANG Lulu;LIANG Yiqian;YANG Aimin;XU Wei;XUE Jianjun(Department of Nuclear Medicine,The First Affiliated Hospital of Xi’an Jiaotong University School of Medicine,Xi’an 710061,P.R.China;Department of Laboratory Division,The First Affiliated Hospital of Xi’an Jiaotong University School of Medicine,Xi’an 710061,P.R.China)

机构地区：[1]西安交通大学医学院第一附属医院核医学科,西安710061 [2]西安交通大学医学院第一附属医院检验科,西安710061

出　　处：《中国普外基础与临床杂志》2021年第11期1457-1461,共5页Chinese Journal of Bases and Clinics In General Surgery

摘　　要：目的探讨^(99)Tc^(m)-甲氧基异丁基异腈(^(99)Tc^(m)-MIBI)双时相显像对甲状旁腺腺瘤(PA)和甲状旁腺增生(PH)的诊断价值。方法回顾性收集西安交通大学医学院第一附属医院2011年7月至2018年12月期间收治的术后病理确诊为甲状旁腺功能亢进症(HPT)的187例患者的临床资料,以术后病理为标准,分析术前^(99)Tc^(m)-MIBI双时相显像的诊断价值。结果PH的血清PTH水平高于PA(Z=–3.23,P<0.01);PA和PH患者的早期病灶放射性计数/对侧正常组织放射性计数(Te/N)均低于延迟T/N(Td/N),差异有统计学意义(Z=–3.61,P<0.01;Z=–3.47,P<0.01);^(99)Tc^(m)-MIBI双时相显像诊断PA和PH病灶的阳性率分别为67.9%(36/53)和20.6%(86/418),诊断PA的阳性率更高(χ^(2)=52.51,P<0.01);^(99)Tc^(m)-MIBI双时相显像诊断PA和PH单发病灶的阳性率均相应高于多发病灶(χ^(2)=15.79,P<0.01;χ^(2)=64.73,P<0.01)。结论 ^(99)Tc^(m)-MIBI双时相显像诊断PA的阳性率较高,但诊断PH的阳性率低。当临床怀疑HPT,而^(99)Tc^(m)-MIBI双时相显像阴性、血清PTH阳性时,需考虑PH,此时应做B超等检查确定病灶部位。Objective To evaluate the diagnostic value of ^(99)Tc^(m)-methoxy isobutyl isonitrile(MIBI)dual-time imaging for parathyroid adenoma(PA)and parathyroid hyperplasia(PH).Methods Clinical data of 187 patients with pathologically confirmed hyperparathyroidism(HPT)who admitted to the First Affiliated Hospital of Xi’an Jiaotong University School of Medicine from July 2011 to December 2018 were retrospectively collected.Taking postoperative pathology as the standard,the diagnostic value of preoperative ^(99)Tc^(m)-MIBI dual-time imaging was analyzed.Results The serum PTH level of PH patients was higher than that of PA patients(Z=–3.23,P<0.01).Te/N(T:focal area radioactive count,N:the normal tissue radioactivity count of the corresponding thyroid gland on the opposite side of the lesion)in PA and PH patients were lower than Td/N(Z=–3.61,P<0.01;Z=–3.47,P<0.01).The positive rates of ^(99)Tc^(m)-MIBI dual-time imaging in the diagnosis of PA and PH lesions were 67.9%(36/53)and 20.6%(86/418),respectively,and the positive rate of PA were higher(χ^(2)=52.51,P<0.01).The positive rate of ^(99)Tc^(m)-MIBI dual-time imaging in the diagnosis of PA and PH single lesions was higher than that of multiple lesions(χ^(2)=15.79,P<0.01;χ^(2)=64.73,P<0.01).Conclusions ^(99)Tc^(m)-MIBI dual-time imaging shows a higher positive rate for PA and a lower positive rate for PH.When HPT is clinically suspected,but ^(99)Tc^(m)-MIBI dual-time imaging is negative and serum PTH is positive,PH should be considered,and B ultrasound and other examinations should be performed to determine the lesion site.

关 键 词：甲状旁腺功能亢进症 ^(99)Tc^(m)-甲氧基异丁基异腈双时相显像 甲状旁腺腺瘤 甲状旁腺增生 诊断 

分 类 号：R736.1[医药卫生—肿瘤] R581[医药卫生—临床医学]