^(99m)Tc-MIBI SPECT/CT联合半定量分析在甲状旁腺功能亢进症术前诊断中的应用  

Discussion on the Application of ^(99m)Tc-MIBI SPECT/CT Combined with Semi-quantitative Analysis in the Preoperative Diagnosis of Hyperparathyroidism

作　　者：陈暐[1] 饶胜芳 李军军 陈莉[1] CHEN Wei;RAO Sheng-fang;LI Jun-jun;CHEN li(Department of Nuclear Medicine,the Second Affiliated Hospital of Nanchang University;Department of Nuclear Medicine,Nanchang University Hospital,Nanchang 330006,China)

机构地区：[1]南昌大学第二附属医院核医学科 [2]南昌大学医院核医学科,南昌330006

出　　处：《实用临床医学(江西)》2025年第1期76-79,共4页Practical Clinical Medicine

基　　金：江西省卫健委科技计划项目(20203334)。

摘　　要：目的比较^(99m)Tc-甲氧基异丁基异腈(^(99m)Tc-MIBI)SPECT/CT断层融合显像及双时相显像在甲状旁腺功能亢进症(HPT)术前定位诊断中的价值,同时对断层融合显像中半定量分析的价值进行初步探讨。方法回顾性分析72例行甲状旁腺切除术患者的病例资料,以术后病理诊断为“金标准”,计算^(99m)Tc-MIBI SPECT/CT断层融合显像及双时相显像对HPT病灶检出的灵敏度和特异度,并初步分析病灶与正常组织的放射性计数比值(T/NT比值)与术前甲状旁腺激素(PTH)水平的关系。结果72例患者中共发现HPT病灶145枚,SPECT/CT断层融合显像和双时相显像检出病灶的灵敏度分别为82.76%(120/145)和65.52%(95/145),2种显像方法比较差异有统计学意义(P=0.001);SPECT/CT断层融合显像的特异度为85.71%(12/14),高于双时相显像特异度71.43%(10/14),但差异无统计学意义(P=0.505);T/NT比值与术前PTH水平呈正相关(r=0.451,P=0.002)。结论^(99m)Tc-MIBI SPECT/CT断层融合显像对HPT病灶的定位诊断有较高的灵敏度,T/NT比值与术前PTH呈正相关,对临床诊断有一定的参考价值。Objective Compare the value of ^(99m)Tc-MIBI SPECT/CT tomographic fusion imaging and dual-phase imaging in the preoperative localization and diagnosis of hyperparathyroidism(HPT),and simultaneously conduct a preliminary exploration of the value of semi-quantitative analysis in tomographic fusion imaging.Methods In a retrospective analysis of 72 cases of parathyroidectomy in our hospital,using the postoperative pathological diagnosis as the gold standard,calculate the sensitivity and specificity of ^(99m)Tc-MIBI SPECT/CT tomographic fusion imaging and dual-phase imaging for the detection of lesions in hyperparathyroidism(HPT),and preliminarily analyze the relationship between the T/NT ratio and the preoperative parathyroid hormone(PTH)level.Results A total of 145 HPT lesions were identified in 72 patients.The sensitivities of SPECT/CT fusion imaging and dual-phase imaging in detecting these lesions were 82.76%(120/145)and 65.52%(95/145),respectively,with a statistically significant difference(P=0.001).The specificity of SPECT/CT fusion imaging was 71.43%(10/14),higher than the specificity of dual-phase imaging,which was 85.71%(12/14).However,there was no statistically significant difference between them(P=0.505).The T/NT ratio of the lesion was positively correlated with the preoperative PTH level(r=0.451,P=0.002).Conclusion ^(99m)Tc-MIBI SPECT/CT fusion imaging exhibits high sensitivity in the localization and diagnosis of HPT lesions.and the T/NT ratio of the lesions was positively correlated with preoperative PTH levels,indicating its high clinical application value.

关 键 词：甲状旁腺功能亢进症 ^(99m)Tc-甲氧基异丁基异腈 SPECT/CT断层融合显像 半定量分析 术前甲状旁腺激素水平 

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