^(99m)Tc-MIBI平面显像及断层显像诊断原发性甲状旁腺功能亢进的效能评价  

Value of ^(99m)Tc-MIBI SPECT planar imaging and tomographic imaging in diagnosis of primary hyperparathyroidism

作　　者：郭月红[1] 黄京伟[1] 常玉婷 杨敏福[1] Guo Yuehong;Huang Jingwei;Chang Yuting;Yang Minfu(Department of Nuclear Medicine,Beijing Chaoyang Hospital,Capital Medical University,Beijing 100020,China)

机构地区：[1]首都医科大学附属北京朝阳医院核医学科,北京100020

出　　处：《首都医科大学学报》2022年第6期873-879,共7页Journal of Capital Medical University

基　　金：北京市医院管理中心“扬帆”计划重点医学专业(ZYLX202105)。

摘　　要：目的探讨^(99m)Tc-甲氧基异丁基异腈(Tc-99m methoxyisobutylisonitrile,MIBI)平面显像及断层显像诊断原发性甲状旁腺功能亢进(primary hyperparathyroidism,PHPT)的效能。方法回顾性分析2019年1月至2021年1月于首都医科大学附属北京朝阳医院疑诊PHPT并在术前完善甲状旁腺^(99m)Tc-MIBI平面显像及断层显像的78例患者的临床及影像资料。分别计算^(99m)Tc-MIBI早期平面显像、延迟平面显像及延迟断层显像的诊断效能,采用χ^(2)检验进行比较。结果78例患者术后病理证实PHPT 75例。从患者水平分析,早期平面显像的灵敏度为60.00%(45/75),特异度为66.67%(2/3),准确率为60.26%(47/78);延迟平面显像的灵敏度为81.33%(61/75),特异度为0%(0/3),准确率为78.21%(61/78);延迟断层显像的灵敏度为89.33%(67/75),特异度为66.67%(2/3),准确率为88.46%(69/78);延迟平面显像及断层显像的灵敏度、准确率均显著高于早期平面显像(χ^(2)=8.233,P=0.004;χ^(2)=17.058,P<0.001和χ^(2)=5.898,P=0.015;χ^(2)=16.272,P<0.001)。从病灶水平分析,早期平面显像的灵敏度、特异度和准确率分别为55.42%(46/83),83.33%(5/6)和57.30%(51/89),延迟平面显像的灵敏度、特异度和准确率分别为73.49%(61/83),16.67%(1/6)和69.66%(62/89),延迟断层显像的灵敏度、特异度和准确率分别为90.36%(75/83),66.67%(4/6)和88.76%(79/89);延迟平面显像的灵敏度显著高于早期平面显像(χ^(2)=5.916,P=0.015);延迟断层显像的灵敏度及准确率均显著高于早期平面显像和延迟平面显像(χ^(2)=25.639,P<0.001;χ^(2)=22.364,P<0.001和χ^(2)=7.975,P=0.005;χ^(2)=9.860,P=0.002)。结论^(99m)Tc-MIBI延迟平面显像在原发性甲状旁腺功能亢进术前的诊断效能明显优于早期显像,延迟断层显像可进一步提高诊断的灵敏度和准确率。Objective To assess the diagnostic values of ^(99m)Tc-MIBI SPECT/CT planar imaging and tomographic imaging in preoperative primary hyperparathyroidism(PHPT).Methods A total of 78 patients in Beijing Chaoyang Hospital from 2019 to 2021 with suspected PHPT who underwent pre-operative ^(99m)Tc-MIBI SPECT/CT from January 2019 to January 2021 were retrospectively reviewed.The diagnostic efficacy of early planar imaging,late planar imaging,and tomographic imaging were calculated respectively.The results were compared byχ^(2)test.Results Of all the 78 patients,20 males(25.64%)and 58 females(74.36%)were included,aged 14-78(49.36±14.21)years old.Postoperative pathology confirmed 75 patients with PHPT.At patient level,the sensitivity,specificity,and accuracy of early planar imaging were 60.00%,66.67%,and 60.26%,respectively.The sensitivity,specificity,and accuracy of late planar imaging were 81.33%,0%,and 78.21%,respectively.The sensitivity,specificity,and accuracy of tomographic imaging were 89.33%,66.67%,and 88.46%,respectively.The sensitivity and accuracy were significantly higher in late planar imaging and tomographic imaging than that in early planar imaging(χ^(2)=8.233,P=0.004 andχ^(2)=17.058,P<0.001,χ^(2)=5.898,P=0.015 andχ^(2)=16.272,P<0.001,respectively).At lesion level,the sensitivity,specificity,and accuracy of early planar imaging were 55.42%,83.33%,and 57.30%,respectively.The sensitivity,specificity,and accuracy of late planar imaging were 73.49%,16.67%,and 69.66%,respectively.The sensitivity,specificity,and accuracy of tomographic imaging were 90.36%,66.67%,and 88.76%,respectively.The sensitivity was significantly higher in late planar imaging than that in early planar imaging(χ^(2)=5.916,P=0.015).The sensitivity and accuracy were significantly higher in tomographic imaging than that in early planar imaging and late planar imaging(χ^(2)=25.639,P<0.001;χ^(2)=22.364,P<0.001 andχ^(2)=7.975,P=0.005 andχ^(2)=9.860,P=0.002,respectively).Conclusion The diagnostic values of ^(99m)Tc-MIBI late imaging in pr

关 键 词：原发性甲状旁腺功能亢进(PHPT) ^(99m)Tc-甲氧基异丁基异腈(MIBI) 单光子发射计算机断层显像/电子计算机断层显像(SPECT/CT) 

分 类 号：R581.1[医药卫生—内分泌] R816.6[医药卫生—内科学] R730.44[医药卫生—临床医学]