^(99m)Tc-MIBI双时相显像诊断甲状旁腺功能亢进的临床价值

Clinical value of double phase ^(99m)Tc-MIBI imaging in diagnosing hyperparathyroidism

目的:评价99mTc-MIBI双时相显像在甲状旁腺功能亢进症(甲旁亢)诊断中的临床价值。方法:44例拟诊甲旁亢患者进行了99mTc-MIBI双时相显像。阳性指标为延迟图像上出现异常增高的放射性聚集,显像资料均参照临床最终诊断结果进行评价,并与同期的B超或CT检查作了对比分析。结果:44例患者中,33例确诊为甲旁亢,其中甲状旁腺腺瘤31例(包括异位1例)、甲状旁腺增生1例与甲状旁腺癌1例。诊断灵敏度为90.9%,特异度为100%,准确性为93.2%,同期B超诊断灵敏度和准确性为70%与77.3%。另25例患者有CT资料,12例有阳性发现(60%)。99mTc-MIBI双时相显像在甲旁亢的诊断中具有较高的阳性率,在腺瘤诊断方面较B超和CT具有更高的诊断效能(P<0.05)。结论:99mTc-MIBI双时相显像能较准确的检测功能亢进的甲状旁腺,是患者术前定位的重要辅助诊断手段,值得临床推广应用。

Objective： To evaluate the clinical value of double phase ^99mTc-MIBI imaging in diagnosing hyperparathyroidism. Methods： Forty-four patients with highly suspected hyperparathyroidism underwent double phase ^99mTc-MIBI imaging. Abnormal increase radioactivity in delay imaging stood for positive index. Imaging material were evaluated according to final clinical results and compared with ultrasound or CT. Results： In 44 patients, 33 hyperparathyroidism were proven, including 31 adenomas（ectopic 1）, 1 hyperplasia and 1 carcinoma. The sensitivity and specificity of diagnosis were 90.9%, 100%, respectively. The accuracy of double phase ^99mTc-MIBI imaging was 93.2%. The sensitivity and specificity of ultrasound were 70%, 77.3%, respectively. The sensitivity of CT was 60%. The results showed that double phase ^99mTc-MIBI imaging was superior to ultrasound and CT（P〈0.05）. Conclusion： Double phase ^99mTc-MIBI imaging could accurately diagnose hyperparathyroidism. It is an important localizing method for preoperation which is worthy of generating.