^(99)Tc^(m)-MIBI显像在原发性甲状旁腺功能亢进症术前定位诊断的价值及影响因素  

The Value and Influencing Factors of ^(99)Tc^(m)-MIBI Imaging in Preoperative Diagnosis of Primary Hyperparathyroidism

作　　者：李慧敏 刘举珍 LI Huimin;LIU Juzhen(Department of Nuclear Medicine,Inner Mongolia Autonomous Region People’s Hospital,Hohhot 010000,China)

机构地区：[1]内蒙古自治区人民医院核医学科,内蒙古呼和浩特010010

出　　处：《标记免疫分析与临床》2023年第9期1444-1449,共6页Labeled Immunoassays and Clinical Medicine

摘　　要：目的评价锝99m-甲氧基异丁基异腈(^(99)Tc^(m)-sestamibi,^(99)Tc^(m)-MIBI)显像在原发性甲状旁腺功能亢进症术前定位诊断的价值,并分析其影响因素。方法回顾性分析76例(男性20例,女性56例)临床诊断为原发性甲状旁腺功能亢进症(primary hyperparathyroidism,PHPT)并行手术治疗的患者,所有患者均行^(99)Tc^(m)-MIBI双时相平面显像及同机单光子发射计算机断层/电子计算机断层(single-photon emission computed tomography/computed tomography,SPECT/CT)显像,以术后病理结果为金标准,计算^(99)Tc^(m)-MIBI双时相平面显像和SPECT/CT显像定位诊断的灵敏度,并应用SPSS 26.0软件采用χ^(2)检验比较平面显像和SPECT/CT显像的诊断效能,采用两独立样本t检验、Mann-Whitney U检验和χ^(2)检验比较平面显像、SPECT/CT显像阳性组和阴性组年龄、病灶体积、病灶部位、术前血钙和血清PTH水平的差异。分别建立病灶体积和血清PTH与平面显像阳性关系的受试者关系曲线(receiver operating characteristic,ROC),获得最佳临界值。建立病灶体积与SPECT/CT显像阳性关系的ROC曲线,获得最佳临界值。结果76例患者术后病理证实PHPT 69例。平面显像和SPECT/CT显像诊断的灵敏度分别为87.32%(62/71)和90.14%(64/71),SPECT/CT显像诊断的灵敏度高于平面显像(P<0.05)。平面显像阳性组病灶体积和血PTH大于阴性组,且差异存在统计学意义(Z=-3.448,P=0.001;Z=-2.152,P=0.031),两组间患者年龄、病灶部位及血钙水平差异无统计学意义(t=0.851,P=0.398;χ^(2)=3.031,P=0.082;t=-1.593,P=0.116);SPECT/CT显像阳性组病灶体积大于阴性组,且差异有统计学意义(Z=-2.630,P=0.009),两组间患者年龄、病灶部位、血钙及血PTH差异均无统计学意义(t=-0.211,P=0.834;χ^(2)=0.300,P=0.584;t=-0.849,P=0.399;Z=-1.21,P=0.224)。病灶体积、术前血清PTH与平面显像阳性关系的ROC曲线下面积分别为0.850、0.701,最佳临界值分别为0.360cm^(3)、347.8ng/L;病Objective To evaluate the value of ^(99)Tc^(m)-methoxy-isobutylisonitrile(^(99)Tc^(m)-sestamibi,^(99)Tc^(m)-MIBI)imaging in preoperative diagnosis of primary hyperparathyroidism,and to analyze its influencing factors.Methods A retrospective analysis was performed on 76 patients(20 males,56 females)clinically diagnosed with primary hyperparathyroidism(PHPT)and treated with surgery.all patients underwent ^(99)Tc^(m)-MIBI two-phase planar imaging and single-photon emission computed tomography/computed tomography(SPECT/CT)imaging.The pathological results were considered as the gold standard.The sensitivity of ^(99)Tc^(m)-MIBI two-phase planar imaging and SPECT/CT imaging was calculated.SPSS 26.0 software was used to compare the diagnostic efficiency of planar imaging and SPECT/CT imaging by chi-square test.Two independent samples t-test,Mann-Whitney U test and chi-square test were used to compare age,lesion volume,lesion site,preoperative blood calcium and blood PTH levels between the positive and negative groups of planar imaging and SPECT/CT imaging.Receiver operating characteristic(ROC)curves of lesion volume,serum PTH and positive planar imaging were drawn and cut-off values were obtained.Receiver operating characteristic(ROC)curves of lesion volume and positive SPECT/CT imaging were drawn and cut-off values were obtained.Results Of all 76 patients,postoperative pathology confirmed 69 patients with PHPT.The sensitivity of planar imaging and SPECT/CT imaging were 87.32%(62/71)and 90.14%(64/71),respectively.The sensitivity of SPECT/CT imaging was higher than that of planar imaging(P<0.05).The lesion volume and serum PTH in the positive group were higher than those in the negative group(Z=-3.448 P=0.001;Z=-2.152,P=0.031),while there was no significant difference in age,lesion site and serum calcium level between the two groups(t=0.851,P=0.398;χ^(2)=3.031,P=0.082;t=-1.593,P=0.116);SPECT/CT positive group was larger than the negative group(Z=-2.630,P=0.009),but there were no significant differences in age,lesion site

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

分 类 号：R582.1[医药卫生—内分泌]