摘要
目的:探讨99锝m-甲氧基异丁基异腈(technetium-99m methoxy isobutyl isonitrile,99Tcm-MIBI)断层及同机CT融合显像在原发性甲状旁腺功能亢进症( primary hyperparathyroidism ,PHPT)术前定位诊断中的价值。方法31例PHPT,静脉注射99 Tcm-MIBI 370 MBq后15 min行颈胸部平面显像,90 min行延迟平面显像,然后开始核素断层与CT融合显像。31例同期均行超声检查。所有显像结果与手术病理结果进行比较。结果99 Tcm-MIBI双时相平面显像、99 Tcm-MIBI 核素断层及同机CT 融合显像对PHPT的检出率分别为87.1%和93.5%,2者差异无统计学意义(P>0.05),但均高于超声对PHPT的检出率64.5%,差异均有统计学意义(χ2分别为4.039和7.884,P均<0.05)。99 Tcm-MIBI核素断层及同机CT融合显像对甲状旁腺增生的检出率均为80.0%,高于超声和99 Tcm-MIBI双时相平面显像的40.0%。同机CT融合显像可提供详细的解剖定位,为手术医师提供更多的信息。结论99 Tcm-MIBI断层及同机CT融合显像较单纯的双时相平面显像对PHPT病灶的检出率有所提高,可提供更多的解剖信息,在PHPT的术前定位诊断中有较高的临床价值。
Objective To evaluate the value of technetium-99m methoxy isobutyl isonitrile(99Tcm-MIBI) tomography and integrated CT scan in preoperative localization diagnosis of primary hyperparathyroidism (PHPT). Methods 31 patients with PHPT were selected .15 minutes and 90 minutes ( delayed images ) after intravenous administration of 99 Tcm-MIBI 370 MBq, static anterior planar images of the neck and chest were obtained .99 Tcm-MIBI tomography and integrated CT scan were acquired after the delayed images .All patients received neck ultra-sound scan before surgery .The imaging findings were compared to the pathological results .Results The detec-tion rate of hyperparathyroidism lesions of 99 Tcm-MIBI dual-phase imaging and 99 Tcm-MIBI tomography and regis-tration with integrated CT scan was 87.1%and 93.5%respectively, without statistical significance (P〉0.05). However , they were both higher than ultrasound scan which had a detection rate of 64.5%.The differences had statistical significance (χ2 =4.039 and 7.884 respectively , P〈0.05 ) .The detection rate of parathyroid hyper-plasia of 99 Tcm-MIBI tomography and registration with integrated CT was both 80.0%, higher than that of the ul-trasound test(40.0%)and 99Tcm-MIBI dual-phase imaging(40.0%).The fusion imaging with integrated CT scan provided detailed anatomy data and more information for surgical doctors .Conclusions 99 Tcm-MIBI tomography and registration with integrated CT scan can improve the detection rate of PHPT compared with 99 Tcm-MIBI dual-phase imaging , provide detailed anatomy data , and has high clinical value in preoperative localization diagnosis of PHPT.
出处
《中华内分泌外科杂志》
CAS
2014年第4期322-324,共3页
Chinese Journal of Endocrine Surgery