比较^(18)F-氟代胆碱PET/CT、^(99)Tc^(m)-甲氧基异丁基异腈SPECT/CT及超声诊断甲状旁腺功能亢进症

Comparison on ^(18)F-fluorocholine PET/CT,^(99)Tc^(m)-methoxyisobutylisonitrile SPECT/CT and ultrasound for diagnosing hyperparathyroidism

目的比较^(18)F-氟代胆碱(FCH)PET/CT、^(99)Tc^(m)-甲氧基异丁基异腈(MIBI)SPECT/CT及超声(US)诊断甲状旁腺功能亢进症(HPT)的效能。方法回顾性分析34例HPT患者,术前2个月内均接受^(18)F-FCH PET/CT、^(99)Tc^(m)-MIBI SPECT/CT及US检查;以术中及术后病理结果为参考,评估并比较各方法的诊断效能。结果于34例共切除90处甲状旁腺病灶,病理证实其中81处为甲状旁腺增生或腺瘤组织,7处为甲状腺组织,2处为淋巴结。^(18)F-FCH PET/CT诊断HPT的敏感度、特异度、阳性预测值、阴性预测值及准确率分别为85.19%(69/81)、100%(55/55)、100%(69/69)、82.09%(55/67)及91.18%(124/136),^(99)Tc^(m)-MIBI SPECT/CT分别为74.07%(60/81)、90.91%(50/55)、92.31%(60/65)、70.42%(50/71)及80.88%(110/136),US分别为65.43%(53/81)、98.18%(54/55)、98.15%(53/54)、65.85%(54/82)及78.68%(107/136)。^(18)F-FCH PET/CT诊断HPT的效能高于^(99)Tc^(m)-MIBI SPECT/CT和US(Z=2.290,P=0.022;Z=2.496,P=0.013)。结论^(18)F-FCH PET/CT、^(99)Tc^(m)-MIBI SPECT/CT及US 3种方法中,^(18)F-FCH PET/CT诊断HPT的效能最高。

Objective To compare the efficacy of ^(18)F-fluorocholine(FCH)PET/CT,^(99)Tc^(m)-methoxyisobutylisonitrile(MIBI)SPECT/CT and ultrasound(US)for diagnosing hyperparathyroidism(HPT).Methods Data of 34 patients with HPT who underwent ^(18)F-FCH PET/CT,^(99)Tc^(m)-MIBI SPECT/CT and US within 2 months before surgical operations were retrospectively analyzed.Taken intraoperative and postoperative pathologic findings as the referent standards,the diagnostic efficacy of the above 3 methods were evaluated and compared.Results Totally 90 lesions were excised from 34 patients,81 of which were confirmed to be parathyroid hyperplasia or adenoma tissue,whereas 7 were thyroid tissue and 2 were lymph nodes.The sensitivity,specificity,positive predictive value,negative predictive value and accuracy of ^(18)F-FCH PET/CT for diagnosing HPT was 85.19%(69/81),100%(55/55),100%(69/69),82.09%(55/67)and 91.18%(124/136),respectively,of ^(99)Tc^(m)-MIBI SPECT/CT was 74.07%(60/81),90.91%(50/55),92.31%(60/65),70.42%(50/71)and 80.88%(110/136),respectively,and of US was 65.43%(53/81),98.18%(54/55),98.15%(53/54),65.85%(54/82)and 78.68%(107/136),respectively.The diagnostic efficacy of ^(18)F-FCH PET/CT for HPT was higher than that of ^(99)Tc^(m)-MIBI SPECT/CT and US(Z=2.290,P=0.022;Z=2.496,P=0.013).Conclusion Among ^(18)F-FCH PET/CT,^(99)Tc^(m)-MIBI SPECT/CT and US,^(18)F-FCH PET/CT had the highest diagnostic efficacy of HPT.