^(99m)Tc-MIBI SPECT/CT异机融合显像、^(99m)Tc-MIBI双时相显像及超声在继发性甲状旁腺机能亢进术前定位的诊断价值  

Diagnostic value of^(99m)Tc-MIBI SPECT/CT heterodyne fusion imaging,dual-temporal imaging and ultrasound in the preoperative localization of secondary hyperparathyroidism

作　　者：丁伟平 王旭[1] 田军 杨立慧 周鹏 顾嘉 DING Weiping;WANG Xu;TIAN Jun;YANG Lihui;ZHOU Peng;GU Jia(Department of Nuclear Medicine,Binzhou Medical University Hospital,Binzhou 256603,Shandong,P.R.China;Department of Nuclear Medicine,the 960th Hospital of People′s Liberation Army of China,Jinan 250031,Shandong,P.R.China;Thyroid and Breast Surgery,the 960th Hospital of People′s Liberation Army of China,Jinan 250031,Shandong,P.R.China;Department of Pathology,the 960th Hospital of People′s Liberation Army of China,Jinan 250031,Shandong,P.R.China)

机构地区：[1]滨州医学院附属医院核医学科,山东滨州256603 [2]中国人民解放军联勤保障部队第九六〇医院核医学科,山东济南250031 [3]中国人民解放军联勤保障部队第九六〇医院甲状腺乳腺外科,山东济南250031 [4]中国人民解放军联勤保障部队第九六〇医院病理科,山东济南250031

出　　处：《滨州医学院学报》2025年第1期70-75,99,共7页Journal of Binzhou Medical University

摘　　要：目的评估99m锝-甲氧基异丁基异腈(^(99m)Tc-methoxyisobutylisonitrile,^(99m)Tc-MIBI)单光子发射型计算机断层显像(single-photon emission computed tomography,SPECT)与16排计算机断层扫描(computed tomography,CT)异机融合显像、^(99m)Tc-MIBI双时相平面显像和颈部超声检查在诊断继发性甲状旁腺功能亢进(secondary hyperparathyroidism,SHPT)的敏感性、准确性及其影响因素。方法回顾性分析接受^(99m)Tc-MIBI SPECT/CT异机融合显像、^(99m)Tc-MIBI双时相显像及超声三种检查的SHPT患者127例,根据病理结果比较基于相同病变不同显像方法的敏感性及准确性。根据异机融合显像图像上甲状旁腺病变分为误诊组和非误诊组,进行半定量分析比较两组病变背景比(lesion to background rate,LBR)、最大直径、最短径、体积和病变位置。结果^(99m)Tc-MIBI SPECT/CT异机融合显像的敏感性和准确性分别为96.0%、91.9%,^(99m)Tc-MIBI双时相平面显像的敏感性和准确性分别为67.8%、67.2%,超声的敏感性和准确性分别为61.1%、61.1%。^(99m)Tc-MIBI SPECT/CT异机融合显像在SHPT患者诊断中的敏感性和准确性高于^(99m)Tc-MIBI双时相平面显像和超声(P<0.05)。误诊组患者病灶的LBR、最大直径、最短径和体积分别为(2.02±0.92)、(6.03±2.33)mm、(3.47±0.74)mm、(67.80±85.63)mm 3,非误诊组患者病灶的LBR、最大直径、最短径和体积分别为(4.32±3.16)、(15.04±5.65)mm、(5.02±2.77)mm、(620.20±1219.19)mm 3。两组病灶的LBR、最大直径、最短径和体积比较,P<0.001。结论^(99m)Tc-MIBI SPECT/CT异机融合显像在SHPT患者中显示出比^(99m)Tc-MIBI双时相平面显像和US更高的敏感性和准确性。Objective To evaluate the sensitivity and accuracy of^(99m)Tc-MIBI SPECT with 16-row CT heterogeneous fusion imaging,^(99m)Tc-MIBI dual time-phase planimetry,and cervical ultrasonography in the diagnosis of secondary hyperparathyroidism(SHPT)and the factors influencing them.Methods One hundred and twenty-seven patients with SHPT who underwent^(99m)Tc-MIBI SPECT with 16-row CT heterogeneous fusion imaging,^(99m)Tc-MIBI dual time-phase planimetry,and cervical ultrasonography were retrospectively analyzed.The sensitivity and accuracy of different imaging methods based on lesions were compared according to pathological findings.Parathyroid lesions on heterogeneous fusion images were divided into the misdiagnosed group(MDG)and the non-misdiagnosed group(NMDG).Semi-quantitative analysis was performed to compare the lesion-to-background ratio(LBR)of misdiagnosed versus non-misdiagnosed lesions,maximum diameter,shortest diameter,volume,and lesion location.Results The sensitivity and accuracy of^(99m)Tc-MIBI SPECT with 16-row CT heterogeneous fusion imaging were 96.0%and 91.9%,the sensitivity and accuracy of^(99m)Tc-MIBI dual time-phase planar imaging were 67.8%and 67.2%,and the sensitivity and accuracy of US were 61.1%and 61.1%,respectively.^(99m)Tc-MIBI SPECT with 16-row CT heterogeneous fusion imaging in SHPT patients showed higher sensitivity and accuracy than^(99m)Tc-MIBI dual-temporal planar imaging and US,and the difference was statistically significant(P<0.05).The LBR,maximum diameter,shortest diameter and volume of the lesions in MDG and NMDG patients were(2.02±0.92),(6.03±2.33)mm,(3.47±0.74)mm,(67.80±85.63)mm 3 and(4.32±3.16),(15.04±5.65)mm,(5.02±2.77)mm,(620.20±1219.19)mm 3 respectively,with statistically significant differences(P<0.001).Conclusion^(99m)Tc-MIBI SPECT with 16-row CT heterogeneous fusion imaging showed higher sensitivity and accuracy than^(99m)Tc-MIBI dual time-phase planar imaging and US in patients with SHPT.

关 键 词：^(99m)Tc-甲氧基异丁基异腈 单光子发射型计算机断层显像 计算机断层异机融合显像 继发性甲状旁腺功能亢进 

分 类 号：R817.4[医药卫生—影像医学与核医学]