^(99m)锝-甲氧基异丁基异腈双时相显像在原发性甲状旁腺功能亢进症定位诊断中的应用价值分析

Application Value of Double-Phase ^(99)Tc^m-MIBI Imaging in the Localization Diagnosis of Primary Hyperparathyroidism

目的探讨99m锝-甲氧基异丁基异腈(99Tcm-MIBI)双时相显像在原发性甲状旁腺功能亢进症(PHPT)定位诊断中的应用价值。方法选取11例健康体检者(正常对照组)和35例经手术和病理证实为PHPT的患者(PHPT组),均行99Tcm-MIBI双时相显像,同时采用计算机感兴趣区(ROI)技术计算甲状旁腺组织ROI中平均放射性计数与相邻正常甲状腺组织ROI的摄取比值(T/NT)。同期35例PHPT患者进行B超检查,23例进行CT检查。所有显像结果均与临床手术病理结果进行比较,计算灵敏度;比较正常对照组与PHPT组的99Tcm-MIBI T/NT值。结果 (1)35例PHPT患者,99Tcm-MIBI双时相显像诊断PHPT的灵敏度为91.4%(32/35);同期B超诊断的灵敏度为62.8%(22/35);CT诊断的灵敏度为73.9%(17/23)。99Tcm-MIBI双时相显像诊断PHPT的灵敏度显著高于B超及CT检查,差异有统计学意义(P<0.05),且B超诊断PHPT的灵敏度与CT检查比较,差异亦有统计学意义(P<0.05)。(2)PHPT组早期相及延迟相99Tcm-MIBI T/NT值均显著高于正常对照组,差异有统计学意义(P<0.01)。结论 99Tcm-MIBI双时相显像能较准确地诊断PHPT,具有较高的临床应用价值。

Objective To evaluate the clinical value of double phase ^99mTc^m-MIBI imaging in the localization diagnosis of primary hyperparathyroidism （PHPT） . Methods Double phase ^99mTc^m-MIBI imaging was performed in 11 normal controls and 35 PHPT patients proved by surgery and pathology. Region of interest （ROI） technology was used to calculate average radio- active count of parathyroid tissues and T/NT of adjacent normal tissues. Meanwhile, 35 PHPT patients were given B ultrasound test and 23 eases were given CT test. All the imaging results were compared with surgery and pathology results to calculate sensitivity. The ^99mTc^m- MIBI T/NT values of the control group and PHPT group were compared. Results （ 1 ） In the 35 PHPT patients proved by surgery and pathology, the sensitivity of double - phase 99Tern - MIBI imaging in the diagnosis of PHPT was 91.4% （ 32/35）, while the sensitivity of B ultrasound and CT was 62. 8% （22/35） and 73.9% （17/23） respectively. The sensitivity of double -phase 99Tcm -MIBI imaging was significantly higher than that of ultrasound and CT （P 〈 0. 05 ） , and the difference of sensitivity between ultrasound and CT was also statistically significant （P 〈 0. 05 ） . （2） The ^99mTc^m-MIBI T/NT values of early phase and delayed phase in the PHPT group were both significantly higher than those of the control group （P 〈0. 01 ）. Conclusion Double phase ^99mTc^m- MIBI imaging can accurately diagnose primary hyperparathyroidism and has high clinical value.