^(99m)Tc-MIBI/^(99m)TcO_4^-核素显像定位诊断甲状旁腺功能亢进症  

Dual-phase parathyroid imaging with ^(99m)Tc-MIBI/^(99m)TcO_4^- subtraction for parathyroid localization

作　　者：赵德善[1] 张彤 李险峰[1] 

机构地区：[1]山西医科大学第一临床医学院核医学科,太原030001 [2]Dept of Nuclear Medicine,Montefiore Medical Center

出　　处：《山西医科大学学报》2004年第2期141-143,共3页Journal of Shanxi Medical University

摘　　要：目的　观察比较99mTc MIBI/99mTcO4-双时相减影法与单纯双时相99mTc MIBI甲状旁腺显像定位诊断甲状旁腺功能亢进症 (hyperparathyroidism ,HPT)。 方法　 18例经临床确诊HPT患者 ,行双时相99mTc MIBI甲状旁腺显像 (方法一 ) :静脉注射显像剂99mTc MIBI 74 0MBq后 ,分别于 2 0min(或 30min)和 12 0min时行颈前平面显像。99mTc MIBI/99mTcO4-双时相减影法 (方法二 ) :99mTc MIBI显像后次日 ,静脉注射99mTcO4-370MBq ,10min～ 2 0min后行颈前甲状腺平面显像。与99mTc MIBI影像进行比较分析。结果　 18例HPT患者中 ,经手术证实有 2 3个病灶 ,其中 19个为腺瘤 ,4个为增生 ,未发现癌变病灶。 4例肾功能衰竭患者有 7个病灶 ,2例原发HPT患者各有 2个腺瘤。方法一发现 15个阳性病灶 (15 /2 3,6 5 .2 % ) ,均为腺瘤 ,另有 2个腺瘤和 1个增生病灶诊断可疑阳性 (3/2 3,13.0 % )。方法二发现 18个阳性病灶 (18/2 3,78.3% ) ,其中 17个腺瘤 ,1个增生。方法二将方法一中的 3个可疑病灶明确为阳性。结论　99mTc MIBI/99mTcO4-双时相减影法具有很好的临床应用价值 ,可作为99mTc MIBI双时相甲状旁腺显像的有力补充或替代方法。Objective To compare the efficacyof dual-phase parathyroid imaging with 99m Tc-MIBI/ 99m TcO 4 -subtraction and a single-tracer dual-phase 99m Tc-MIBI parathyroid scintigraphy for parathyroid localization. Methods All 18 patients had a single-tracer dual-phase 99m Tc-MIBI parathyroid planar scintigraphy at20 min (or 30) and 120 min, respectively, after injecting 99m Tc-MIBI 740 MBq intravenously, and a double-tracer subtraction technique using a delayed 99m Tc-pertechnetate scan in 10～20 min after injecting 99m TcO 4 -370 MBq intravenously. Results There were 23 lesions in 18 patientswith hyperparathyroidism identified by surgery, including 19 parathyroid adenoma and 4 parathyroid hyperplasia. Four patients with secondary hyperparathyroidism had 7 lesions and 12 patients with primary hyperparathyroidism had solitary parathyroid adenoma , each of the other 2 patients with primary hyperparathyroidism had 2 lesions, respectively. There were 15 positive lesions(15/23, 65.2%) and 3 suspicious positive lesions(3/23, 13.0%) including 2 parathyroid adenoma and 1 parathyroid hyperplasia in single-tracer dual-phase 99m Tc-MIBIparathyroid scintigraphy. There were 18 positive lesions(18/23, 78.3%), including 17 parathyroid adenoma and 1 parathyroid hyperplasia,and 3 suspicious positive lesions in dual-phase 99m Tc-MIBI parathyroid scintigraphy showedpositive results in dual-phase parathyroid imaging with 99m Tc-MIBI/ 99m TcO 4 -subtraction. Conclusion The dual-phase parathyroid imaging with 99m Tc-MIBI/ 99m TcO 4 - subtraction is a useful clinical imaging method and a good complementarity or substitution of single-tracer dual-phase 99m Tc-MIBI parathyroid scintigraphy.

关 键 词：^99MTC-MIBI ^99mTcO4^- 核素显像 定位诊断 甲状旁腺功能亢进症 微创手术 

分 类 号：R581.1[医药卫生—内分泌]