影像学检查在原发性甲状旁腺功能亢进症术前定位中的作用  

Value of preoperative imaging localization for primary hyperparathyroidism

作　　者：韩恩昆[1] 刘自宽[1] 高硕[1] 白人驹[1] 王鹏志[1] 朱理伟[1] 

机构地区：[1]天津医科大学总医院普外科

出　　处：《中华普通外科杂志》2004年第4期219-221,共3页Chinese Journal of General Surgery

摘　　要：目的比较B超、CT、99mTc MIBI对于甲状旁腺功能亢进病灶定位诊断的价值。方法经手术及病理证实为原发性甲旁亢的 4 7例患者中 ,B超检查 4 5例 ,CT扫描 4 7例 ,99mTc MIBI核素显像 36例。结果 4 7例患者共摘除 4 6枚腺瘤 ,切除腺癌 2例 ,增生腺体 2例。B超、CT、99mTc MIBI的灵敏性分别为 4 3% ,78% ,92 % ;特异性为 96 % ,97% ,10 0 % ;准确性为 82 % ,92 % ,98% ;99mTc MIBI与CT在灵敏性和准确性方面差异有显著性 (χ2 =6 6 2 7,χ2 =4 884 ,均P <0 0 5 ) ,99mTc MIBI和CT在灵敏性和准确性方面优于B超 (χ2 CT =2 4 186 ,χ2 MIBI=5 2 5 12 ;χ2 CT =4 15 8,χ2 MIBI=9 0 0 2 ,均P <0 0 5 ) ,但特异性上三种方法近似。结论　99mTc MIBI双时相法对于甲状旁腺腺瘤的定位诊断是一种很有应用前途的方法。Objective To evaluate US, CT and 99mTc-MIBI in the localization of hyperfunctioning parathyroid tumors. Methods Among the 47 patients with primary hyperparathyroidism 45 underwent ultrasound, 47 did CT scan and 36 did double phase imagings. Results Forty-six adenomas, 2 adenocarcinomas and 2 hyperplastic glands were removed from 47 patients. The results showed that the sensitivities were 43%,78%,92% for B-utrasound; CT and isotope imaing respectively.The specificities were 96%,97%,100%;and the accuracies were 82%,92%,98%. There was significant difference between 99mTc- MIBI and CT (χ 2=6.627,χ 2=4.884,P<0.05), and 99mTc-MIBI and CT were superior to B-US in sensitivity and accuracy (χ2 CT=24.186,χ2 MIBI=52.512;χ2 CT=4.158,χ2 MIBI=9.002,P<0.05), the specificity was similar for all of three imaging methods. Conclusions Double-phase 99mTc-MIBI imaging are promising technique for localization of parathyroid adenomas .

关 键 词：影像学检查 原发性甲状旁腺功能亢进症 术前定位 诊断 B超检查 CT扫描 

分 类 号：R653[医药卫生—外科学]