不同时相99mTc-MIBI SPECT/CT双时相法对甲状旁腺功能亢进症诊断效能的影响

Effect of 99mTc-MIBI SPECT/CT two-phase SPECT on diagnostic efficacy of hyperparathyroidism

目的探讨^99m锝-甲氧基异丁基异腈(^99m technetium-methoxyisobutyl isonitrile,^99m Tc-MIBI)单光子发射型计算机断层显像/计算机断层扫描(SPECT/CT)双时相法的不同时相点对甲状旁腺功能亢进症诊断效能的影响。方法纳入2017年6月至2018年6月在本院诊断为甲状旁腺功能亢进症并接受手术治疗的患者68例,术前行^99m Tc-MIBI SPECT/CT双时相法的不同时相点20、60、90 min显像及相应时间(60、90 min)同机断层融合显像。以病理结果为金标准,比较不同时相点双时相法的诊断效能。结果 68例患者术后确诊为原发性甲状旁腺功能亢进症(primary hyperparathyroidism, PHPT)15例,继发性甲状旁腺功能亢进症(secondary hyperparathyroidism, SHPT)53例。20 min和60 min双时相组诊断灵敏性和准确率分别为66.10%、71.14%,其60 min同机断层融合显像分别为80.45%、82.38%,20 min和90 min双时相组诊断灵敏性和准确率分别为68.25%、74.68%,其90 mim同机断层融合显像分别为83.58%、85.70%;两组双时相法的不同时相点检测方法灵敏性和准确率的差异无统计学意义(P>0.05);而相应时间点同机断层融合显像检测方法与双时相显像的灵敏性和准确率的差异有统计学意义(P<0.05)。结论 ^99m Tc-MIBI双时相的延迟相显像时间及相应时间点同机断层融合显像提前至60 min,并不降低其诊断效能。

Objective To evaluate the effect of ^99m technetium-methoxyisobutyl isonitrile(^99m Tc-MIBI) single photon emission computed tomography/computed tomography(SPECT/CT) with different time-phase points on the diagnostic efficiency of hyperparathyroidism. Methods Sixty-eight patients with hyperparathyroidism admitted in our hospital from June 2017 to June 2018 were recruited in this study. Preoperative imaging of ^99m Tc-MIBI with different simultaneous phase points(20, 60 and 90 min) and the corresponding time(60 and 90 min) with SPECT/CT fusion imaging were performed in all patients. The results of surgical pathology were used as the golden standard, and the diagnostic efficacy of simultaneous phase fusion imaging at different time points and corresponding time points was compared. Results Among the 68 patients, 15 were diagnosed as primary hyperparathyroidism(PHPT) and 53 as secondary hyperparathyroidism(SHPT). The diagnostic sensitivity and accuracy of the dual phase imaging group(20 and 60 min) were 66.10% and 71.14% respectively, and the corresponding time points of 60 min SPECT/CT fusion imaging of the same machine were 80.45% and 82.38% respectively;the diagnostic sensitivity and accuracy of the dual phase imaging group(20 and 90 min) were 68.25% and 74.68% respectively, and the corresponding time points of 90 min SPECT/CT fusion imaging of the same machine were 83.58% and 85.70% respectively. There were no significant differences in sensitivity and accuracy between the 2 groups of dual-phase imaging with different imaging time(P>0.05), while statistical differences were seen in sensitivity and accuracy between the corresponding time point fault fusion imaging and dual-phase imaging(P<0.05). Conclusion When ^99m Tc-MIBI dual-phase delays phase imaging time and the corresponding point fault fusion imaging advances to 60 min, it has no effect on its diagnostic efficiency for hyperparathyroidism.