^(99)Tc^(m)-MIBI显像在甲状旁腺功能亢进术前诊断中的应用价值  

The value of^(99)Tc^(m)-MIBI imaging on the preoperative diagnosis of hyperparathyroidism

作　　者：杨易剑 王俊超 浦晓佳 邵科晶 朱宝 Yang Yijian;Wang Junchao;Pu Xiaojia;Shao Kejing;Zhu Bao(Department of Nuclear Medicine,Wuxi People’s Hospital Affiliated to Nanjing Medical University,Wuxi 214028,China)

机构地区：[1]南京医科大学附属无锡人民医院核医学科,无锡214028

出　　处：《现代仪器与医疗》2022年第3期35-38,42,共5页Modern Instruments & Medical Treatment

摘　　要：目的探讨99m锝标记的甲氧基异丁基异腈(^(99)Tc^(m)-MIBI)甲状旁腺显像在甲状旁腺功能亢进患者术前诊断中的应用价值.方法回顾性分析45例临床诊断为甲状旁腺功能亢进的患者临床资料和影像学资料,所有患者术前均行颈部超声、^(99)Tc^(m)-MIBI双时相平面显像、SPECT/CT融合显像,以手术病理结果为"金标准",比较不同方法的诊断灵敏度和病灶检出率,并且探讨不同方法的诊断灵敏度与术前血清甲状旁腺激素(PTH)水平的相关性.结果45例患者经病理共发现甲状旁腺病灶138处(甲状旁腺增生病灶130处,甲状旁腺腺瘤病灶8处).超声、平面显像、SPECT/CT显像对患者的诊断灵敏度分别为51.1%(23/45)、91.1%(41/45)、100%(45/45),病灶检出率分别为35.5%(49/138)、63.8%(88/138)、75.4%(104/138).平面显像、SPECT/CT显像诊断灵敏度和病灶检出率均明显高于超声,差异有统计学意义(均P<0.01).SPECT/CT显像的诊断灵敏度和病灶检出率稍高于平面显像,但差异无统计学意义(均P>0.05).三种不同影像学检查方法的诊断灵敏度与术前PTH水平无相关性.结论与超声相比,^(99)Tc^(m)-MIBI甲状旁腺显像具有更高的诊断灵敏度和病灶检出率,尤其是SPECT/CT显像还能同时提供精确的解剖信息,对术前定位甲状旁腺病灶有着重要应用价值.Objective To explore the application value of^(99)Tc^(m)-MIBI imaging on the preoperative diagnosis of hyperparathyroidism(HPT).Methods Forty-five patients with HPT were retrospectively enrolled.They all underwent neck ultrasound,^(99)Tc^(m)-MIBI dual-phase planar imaging and SPECT/CT hybrid imaging before surgery.Took pathological results as the golden standard,the diagnostic sensitivities and detection rates of the three imaging methods were compared,and studied the relation between the serum PTH level and the sensitivities.Results A total of 138 parathyroid lesions were confirmed by pathology(8 parathyroid adenomas,and 130 hyperplastic parathyroid lesions).The diagnostic sensitivities of ultrasound,^(99)Tc^(m)-MIBI dual-phase planar imaging,SPECT/CT hybrid imaging were 51.1%(23/45),91.1%(41/45),100%(45/45),respectively.The detection rate were 35.5%(49/138),63.8%(88/138),75.4%(104/138),respectively.Diagnostic sensitivities and detection rates of dual-phase planar imaging and SPECT/CT hybrid imaging were higher than that of ultrasound(all P<0.05).However,there were no remarkable differences between the planar imaging and SPECT/CT hybrid imaging(all P<0.05).There was no significant relation between serum PTH level and those different imaging methods in sensitivities.Conclusion Compared with ultrasound,nuclide imaging including^(99)Tc^(m)-MIBI dual-phase planar imaging and SPECT/CT hybrid imaging had higher diagnostic sensitivities and detection rates.Especially,SPECT/CT hybrid imaging could be of more important application value for preoperative localization of HPT owing to its accurate anatomical localization ability.

关 键 词：甲状旁腺功能亢进症 单光子发射型计算机断层显像 甲氧基异丁基异腈 平面显像 融合显像 

分 类 号：R582.1[医药卫生—内分泌]