^(18)F-FCH PET/CT在原发与继发性甲状旁腺功能亢进中的对比研究  

A comparative study of ^(18)F-FCH PET/CT in primary and secondary hyperparathyroidism

作　　者：费子航 王政杰[1] 勾亚婷 庞华[1] FEI Zi-hang;WANG Zheng-jie;GOU Ya-ting(Department of Nuclear Medicine,the First Affiliated Hospital of Chongqing Medical University,Chongqing 400016,China)

机构地区：[1]重庆医科大学附属第一医院核医学科,重庆400010 [2]重庆医科大学附属大学城医院放射科,重庆400010

出　　处：《放射学实践》2025年第1期107-113,共7页Radiologic Practice

基　　金：18F-氟代胆碱PET/CT对甲状旁腺亢进的诊断效能及临床应用研究(科委卫建委联合项目:2021MSXM087)。

摘　　要：目的:对比^(18)F-FCH PET/CT在原发性甲状旁腺功能亢进(PHPT)与继发性甲状旁腺功能亢进(SHPT)中的应用价值,并比较18F-FCH PET/CT影像参数在两者间的差异。方法:回顾性搜集行^(18)F-FCH PET/CT显像的甲状旁腺亢进症患者50例(PHPT 28例,SHPT 22例)。通过t检验或非参数检验、Spearman相关性分析比较其临床生化指标、^(18)F-FCH PET/CT显像参数及其诊断效能等方面的差异,比较^(18)F-FCH PET/CT相关参数在PHPT与SHPT间的差异,同时探讨临床生化指标与PET参数间的相关性。结果:血钙、血磷、甲状旁腺激素、降钙素、MTV总和、TLFM总和在PHPT与SHPT两组间差异有统计学意义(P均<0.05),而SUV_(max)差异无统计学意义(P=0.072)。^(18)F-FCH PET/CT检测PHPT更具优势,其诊断敏感度(分别为96.8%和74.6%)和阳性预测值(分别为96.8%和89.8%)均高于SHPT。血磷水平、SUV_(mean)总和鉴别诊断PHPT与SPHT的效能优于其他指标,其截断值分别为1.175(AUC=0.918)、3.4(AUC=0.8417)。PTH与SUV_(max)、MTV总和、TLFM总和等PET参数存在正相关性,其余临床指标与PET参数无明显相关性。结论:部分^(18)F-FCH PET/CT影像参数及临床生化指标在PHPT与SHPT间差异有统计学意义,且PET/CT影像参数对PHPT的检测效能明显高于SHPT。在甲状旁腺功能亢进患者中,甲状旁腺激素与SUV_(max)、MTV总和、TLFM总和具有正相关性。Objective:The aim of this study was to compare the application value of ^(18)F-FCH PET/CT in primary hyperparathyroidism(PHPT)and secondary hyperparathyroidism(SHPT),and to compare the difference of ^(18)F-FCH PET/CT image parameters between PHPT and SHPT.Methods:Fifty patients with hyperparathyroidism(28 cases of PHPT,22 cases of SHPT)who underwent ^(18)F-FCH PET/CT imaging were retrospectively collected.A t test or nonparametric test and Spearman correlation analysis were used to compare the differences of clinical biochemical indexes,^(18)F-FCH PET/CT imaging parameters and diagnostic efficiency,and to compare the differences of ^(18)F-FCH PET/CT relevant parameters between PHPT and SHPT.The correlation between clinical biochemical indexes and PET parameters was also discussed.Results:There were statistically significant differences in serum calcium,serum phosphorus,parathyroid hormone(PTH),calcitonin,MTV sum,and TLFM sum between PHPT and SHPT groups(P<0.05),but no statistically significant difference in SUV max(P=0.072).^(18)F-FCH PET/CT showed higher sensitivity(96.8%vs.74.6%)and higher positive predictive value(96.8%vs.89.8%)in detecting PHPT than in detecting SHPT.Blood phosphorus level and SUV mean sum were superior to other indexes in differentiating PHPT and SPHT,with cut-off value of 1.175(AUC:0.918)and 3.4(AUC:0.8417),respectively.PTH showed a positive correlation with PET parameters such as SUV max,MTV sum and TLFM sum,while the remaining clinical indicators showed no significant correlation with PET parameters.Conclusion:Part of the ^(18)F-FCH PET/CT parameters and clinical biochemical indicators are statistically significantly different between PHPT and SHPT.The efficacy of ^(18)F-FCH PET/CT parameters of PHPT is significantly higher than that of SHPT.In patients with hyperparathyroidism,PTH showes a positive correlation with SUV max,the sum of MTV,and total TLFM.

关 键 词：甲状旁腺功能亢进症 ^(18)F-FCH PET/CT 正电子发射计算机体层成像 体层摄影术 X线计算机 

分 类 号：R582.1[医药卫生—内分泌] R817.4[医药卫生—内科学]