^(99)Tc^m-MDP骨显像诊断甲状旁腺瘤

Application of radionuclide imaging in diagnosis of hyperftmctioning parathyroid glands

目的 探讨^(99)Tc^m-亚甲基二膦酸盐(MDP)骨显像诊断甲状旁腺瘤的价值。方法 回顾性分析26例甲状旁腺瘤患者骨显像和^(99)Tc^m-甲氧基异丁基异腈(MIBI)甲状旁腺瘤显像的特点,并与其他相关疾病相鉴别。26例皆行B超检查,其中18例行^(99)Tc^m-MIBI颈部显像。结果 核素显像诊断的26例甲状旁腺瘤皆经手术治疗、病理检查证实,其中2例为异位甲状旁腺瘤,1例为甲状旁腺癌。26例^(99)Tc^m-MDP骨显像皆清晰,呈全身骨转换增加的代谢性骨病征,代谢指数≥5,典型表现特点为“黑颅”和骨显像清晰。18例^(99)Tc^m-MIBI显像皆可见甲状旁腺瘤,其中3例B超检查未见。结论 对骨痛和病理性骨折患者行全身骨显像有助于甲状旁腺功能亢进导致代谢性骨病的病因诊断,与甲状旁腺瘤显像联合应用,可准确诊断和定位甲状旁腺癌。

Objective To evaluate the role of radionuclide imaging in diagnosis of hyperfunctioning parathyroid tumor and early etiology ascertaining of bone pain and pathologic fracture. Methods Retrospectively studied on the data of radionuclide imaging using 99Tcm-methylene diphosphonic acid (MDP) and 99Tcm-methoxyisobu-tylisonitrile (MTBI). The data was collected from 26 cases with hyperfunctioning parathyroid glands by orthopedics department in this hospital .during the last 11 years. Results Operations and pathologic studies had been performed on all of the 26 cases, including 2 cases with adenoma and 1 case with carcinoma. All cases showed obvious signs of general skeletal metabolic change of hyperparathyroidism oh bone scintigraphy. All the metabolic indexes were ≥5. The features of typical appearance were the ' black skull' and extraordinarily clear bone images. Total 26 cases underwent ultrasonography of the neck and 18 cases of them had double-phase radionuclide parathyroid imaging. All of the 18 cases had positive results and showed accurate position of glands in double-phase hy-perparathyroid radionuclide imaging. Conclusion Signs of bone metabolic change of hyperparathyroidism in bone scintigraphy for the patients with bone pain and pathologic fracture are necessary for the early etiological ascertaining; the hyperfunctioning parathyroid glands can be showed accurately in the parathyroid radionuclide imaging, and that is very important for diagnosing and locating hyperfunctioning parathyroid tumors.