多模态影像学术前定位诊断原发性及继发于慢性肾病的甲状旁腺功能亢进症  

Multimodal imaging for preoperative localization diagnosis of primary and secondary hyperparathyroidism due to chronic renal disease

作　　者：梅威琪 江茂情 马丽娟 褚玉[2] 闯振蕾 冯金 王珏[3] 楼岑[1] MEI Weiqi;JIANG Maoqing;MA Lijuan;CHU Yu;CHUANG Zhenlei;FENG Jin;WANG Jue;LOU Cen(Department of Nuclear Medicine,Sir Run Run Shaw Hospital,Zhejiang University School of Medicine,Hangzhou 310000,China;Department of Nuclear Medicine,Ningbo No.2 Hospital,Ningbo 315000,China;Department of Ultrasound,Ningbo No.2 Hospital,Ningbo 315000,China)

机构地区：[1]浙江大学医学院附属邵逸夫医院核医学科,浙江杭州310000 [2]宁波市第二医院核医学科,浙江宁波315000 [3]宁波市第二医院超声科,浙江宁波315000

出　　处：《中国医学影像技术》2023年第10期1492-1496,共5页Chinese Journal of Medical Imaging Technology

基　　金：宁波市省市共建重点学科-医学影像学(2022-S02);宁波市影像医学临床医学研究中心(2021L003);宁波市第二医院朱绣山人才激励基金-华美优青(2021hmyq07)。

摘　　要：目的对比^(99)Tc^(m)-MIBI双时相平面显像、SPECT/CT显像与超声术前定位诊断原发性甲状旁腺功能亢进症(PHPT)及继发于慢性肾病的甲状旁腺功能亢进症(SHPT)的价值。方法纳入113例术前接受^(99)Tc^(m)-MIBI双时相平面显像、SPECT/CT显像和颈部超声检查的甲状旁腺功能亢进症(HPT)患者,包括95例PHPT及18例慢性肾病SHPT;以术后病理为标准,分析各影像学方法术前定位诊断的价值。结果术后病理共于95例PHPT中诊断108处病灶,其中90处显像阳性、18处阴性;于18例慢性肾病后SHPT中诊断46处病灶,其中44处显像阳性、2处阴性。双时相平面显像、SPECT/CT显像和超声定位诊断PHPT的准确率分别为87.96%(95/108)、92.59%(100/108)和79.63%(86/108),定位诊断慢性肾病后SHPT准确率分别为58.70%(27/46)、86.96%(40/46)和71.74%(33/46),双时相平面显像对前者显著高于后者(P<0.001)。双时相平面显像、SPECT/CT显像及超声诊断PHPT准确率差异均无统计学意义(P均>0.05);对于慢性肾病后SHPT,SPECT/CT显像诊断准确性率显著高于双时相平面显像(P=0.004)而与超声差异无统计学意义(P=0.121),双时相平面显像与超声差异亦无统计学意义(P=0.274)。结论^(99)Tc^(m)-MIBI双时相平面显像、SPECT/CT显像及超声术前定位诊断HPT准确率较高。双时相平面显像诊断PHPT效能优于慢性肾病后SPHT;推荐对慢性肾病后SHPT优先行SPECT/CT显像。Objective To compare the value of^(99)Tc^(m)-MIBI dual phase planar imaging,SPECT/CT imaging and ultrasonography for preoperative localization diagnosis of primary hyperparathyroidism(PHPT)and secondary hyperparathyroidism(SHPT)due to chronic renal disease.Methods Data of 113 patients with hyperparathyroidism(HPT)who underwent^(99)Tc^(m)-MIBI dual phase planar imaging,SPECT/CT imaging,and cervical ultrasonography before operation were analyzed,including 95 cases of PHPT and 18 cases of SHPT due to chronic renal disease.The value of each imaging method for preoperative localization diagnosis was evaluated according to postoperative pathology.Results Postoperative pathology diagnosed 108 lesions in 95 cases of PHPT,including 90^(99)Tc^(m)-MIBI dual phase planar imaging or SPECT/CT imaging positive lesions and 18 negative lesions,also 46 lesions in 18 patients with SHPT due to chronic renal disease,including 44 imaging positive and 2 negative lesions.The accuracy of dual phase plane imaging,SPECT/CT imaging and ultrasonography for localization diagnosis of PHPT was 87.96%(95/108),92.59%(100/108)and 79.63%(86/108),while for SHPT due to chronic renal disease was 58.70%(27/46),86.96%(40/46),and 71.74%(33/46),respectively.The accuracy of dual phase plane imaging for preoperative localization diagnosis of PHPT was significantly higher than that of SHPT due to chronic renal disease(P<0.001).No significant difference of diagnostic accuracy was found among dual phase plane imaging,SPECT/CT imaging and ultrasonography for preoperative localization diagnosis of PHPT(all P>0.05).For SHPT due to chronic renal disease,the diagnostic accuracy of SPECT/CT imaging was significantly higher than that of dual phase plane imaging(P=0.004)but not significantly different compared with that of ultrasonography(P=0.121),and no significant difference was found between dual phase plane imaging and ultrasonography(P=0.274).Conclusion^(99)Tc^(m)-MIBI dual phase plane imaging,SPECT/CT imaging and ultrasonography had high efficacy for preoperativ

关 键 词：甲状旁腺功能亢进症 体层摄影术 发射型计算机 单光子 超声检查 

分 类 号：R582.1[医药卫生—内分泌] R445[医药卫生—内科学] R817[医药卫生—临床医学]