^(99m)Tc-MIBI/^(99m)TcO_4^-显像在诊断原发性甲状旁腺机能亢进症(PHPT)的应用价值

The Clinical Value of ^(99m)Tc-MIBI/^(99m)TcO_4^- Scintigraphy in Diagnosis of Primary Hyperparathyroidism

目的评价99mTc-MIBI(99mTc-甲氧基异丁基异腈/99mTcO-4)显像在原发性甲状旁腺机能亢进症(PHPT)术前诊断中的临床价值。方法38例临床拟诊PHPT患者进行99mTc-MIBI显像,静脉注射99mTc-MIBI20～25mCi后5min、15min行早期相甲状旁腺显像,2h后行延迟相显像,10例患者于检查第2天静脉注射99mTcO-4进行甲状腺显像。将显像结果与临床确诊结果进行对比分析和评价。结果38例中有31例确诊为PHPT,其中甲状旁腺腺瘤29例(包括异位瘤2例),甲状旁腺增生2例,99mTc-MIBI/99mTcO-4显像检出28例,99mTc-MIBI/99mTcO-4显像诊断灵敏度为90.3%,特异性为100%,准确性为92.11%。结论99mTc-MIBI/99mTcO-4显像在原发性甲状旁腺机能亢进症(PHPT)诊断中有较高的应用价值。

Objective To evaluate the clinical value of ^99mTc-MIBI/^99mTcO^-4 scintigraphy in diagnosis of primary hyperparathyroidism （PHPT）. Methods Thirty-eight cases with highly suspected hyperparathyroidism underwent double-phase^99mTc-MIBI imaging, Parathyroid imaging was performed both at 5 min, 15min（early phase imaging） and 2h （delayed phase imaging） after intravenous injection of 20-25 mCi ^99mTc-methoxyisobutylisonitrile （MIBI）, 10 patients of them underwent ^99mTcO^-4 thyroid scintigraphy next day, thyroid imaging was performed after intravenous injection of 5mCi^99mTcO^-4, Imaging material were evaluated according to final clinical results. Results In 38 patients, 31 hyperparathyroidism were proven, including 29 adenomas （ectopic 2）, 2 hyperplasia. ^99mTc-MIBI/^99mTcO^-4 imaging were 90.3%,100%,92.11%. Conclusions ^99mTc-MIBI/^99mTcO^-4scintigraphy is an effective method in diagnosis of primary hyperparathyroidism（PHPT）.