甲状旁腺腺瘤^(99)Tc^m-MIBI摄取与生物化学指标的相关性研究

Relation between ^(99)Tc^m-MIBI uptake and biological factors in patients with parathyroid adenoma

目的探讨双时相甲状旁腺显像的99Tcm-MIBI摄取与血清生化指标(iPTH、Ca2+、P、Mg2+)、瘤体大小的关系。方法对23例甲状旁腺腺瘤患者的核素显像、血清生化指标、病理进行回顾性分析。图像采用腺瘤部位及对侧甲状腺的计数比值(P/T)进行半定量分析,求出早期及延迟显像的P/T值(P/T1、P/T2),并分组进行比较(A组:P/T2≥P/T1,B组:P/T2<P/T1)。结果 P/T1、P/T2与血Ca2+、Mg2+、腺瘤大小均无相关性,P/T1与术前iPTH呈正相关(P<0.05),P/T2与术前血P呈负相关(P<0.05)。B组术前血Ca2+高于A组(P<0.01),手术前后血Ca2+的变化值大于A组(P<0.01)。结论血清iPTH、P水平以及其病理特性,有可能都是影响腺瘤MIBI摄取的因素,在行甲状旁腺显像时应加以考虑。

Objective To correlate the semiquantitative analysis of 99Tcm-methoxyisobutyl isonitrile（MIBI） double phases scan with serum biochemical values（iPTH,Ca2＋,P,Mg2＋） and tumor volume of parathyroid adenoma.Methods Early（15 min） and delayed（120 min） anterior plannar images of MIBI scans were reviewed in 23 patients who eventually underwent parathyroid adenoma ectomies.The ratio of parathyroid to thyroid（P/T） was determined by average counts of the diseased parathyroid gland and normol thyroid gland.The patients were divided into 2 groups：Group A（P/T2≥P/T1）,Group B（P/T2P/T1）.Result There was a positive correlation between P/T1 and preoperative serum iPTH（P0.05）.And there was a adverse correlation between P/T1 and preoperative serum phosphorus values（P0.05）.However,there was no significant correlation between P/T2 and serum biochemical values.Additionally,no correlation between MIBI uptake ratios and increased gland volume was found.Group B had a high value in the preoperative Ca2＋（P0.01） and variation of perioperative Ca2＋（P0.01）.Conclusion The serum iPTH levels and phosphorus value may have an effect on MIBI uptake,and should be considered prior to MIBI imaging.