SPECT-CT ^(99m)Tc-MIBI显像在纵隔内异位甲状旁腺诊治中的应用价值

Application of SPECT-CT ^(99m)Tc-MIBI imaging in the diagnosis and therapy of mediastinal ectopic parathyroid in secondary hyperparathyroidism

目的 探讨SPECT-CT99mTc-MIBI双时相显像对继发性甲状旁腺功能亢进症患者,纵隔内异位甲状旁腺的精确定位诊断价值。方法 98例继发性甲状旁腺功能亢进症的患者进行99mTc-MIBI双时相平面和断层显像,所有患者均进行同机诊断CT成像。对纵隔内异常放射性浓聚灶融合图像分析、定位。结果 发现纵隔内异位甲状旁腺6例(6/98,6.1%)。其中4例甲状旁腺切除术后患者:3例仅见纵隔甲状旁腺显影,另1例患者的有2处甲状旁腺,分别定位于甲状腺左叶和纵隔内;2例药物治疗患者中有1例仅见纵隔甲状旁腺显影,另1例患者也为2处甲状旁腺,分别定位于甲状腺右叶后方和纵隔内。结论 99mTc-MIBISPECT-CT显像真正做到了解剖图像和功能图像的融合,是最有效的探测异位甲状旁腺的方法,可帮助外科医生缩小探查范围,缩短手术时间,更容易找到异位甲状旁腺。

Objective To discuss the value of SPECT-CT 99mTc-MIBI dual-phase imaging in the precise localization of mediastinal ectopic parathyroid in secondary hyperparathyroidism. Methods A total of 98 patients with secondary hyperparathyroidism 99mTc-MIBI dual-phase planar and SPECT imaging. All SPECT imaging combined CT scan. Analysis and localization of fusing images were focused on the abnormal radionuclide foci in mediastinum. Results Six mediastinal ectopic parathyroid glands were found (6/98, 6.1%). In the 4 patients after parathyroidectomy, 3 cases were found to have a solitary ectopic parathyroid in mediastinum, and one case had two parathyroid glands located in the left lobe of thyroid and mediastinum. In the 2 cases treated with medication, one case was found to have a solitary ectopic parathyroid in mediastinum, and one had two parathyroid glands located in the right posterior lobe of thyroid and mediastinum. Conclusion 99mTc-MIBI SPECT-CT imaging makes a true fusion of anatomical and functional images. This method provides the most effective approach to detect ectopic parathyroid, and helps surgeons limit operation area, shorten operation time and move the gland easier.