^99mTc-MIBI显像在原发性甲状旁腺功能亢进定位诊断中的应用价值

Clinical value of ^(99m)Tc-MIBI imaging in the localization diagnosis of primary hyperparathyroidism

目的:评价^(99m)Tc-甲氧基异丁基异腈(^(99m)Tc-MIBI)显像在原发性甲状旁腺功能亢进症(PHPT)定位诊断中的临床应用价值。方法:回顾性分析57例疑似PHPT患者^(99m)Tc-MIBI显像、血清PTH测定及B超检查结果,以术后病理为金标准,对^(99m)Tc-MIBI双时相显像、血清PTH测定及B超检查三种诊断方法的灵敏度、特异度、准确度进行比较和评价。结果:术后病理证实,57例患者^(99m)Tc-MIBI显像与血清PTH测定两种诊断方法比较,灵敏度、特异度、准确度分别为91.49%(80.85%)、50.00%(80.00%)、84.42%(80.70%);^(99m)Tc-MIBI显像与B超检查两种诊断方法比较,灵敏度、特异度、准确度分别为91.49%(76.60%)、50.00%(70.00%)、84.21%(75.44%)。结论:^(99m)Tc-MIBI显像对PHPT定位诊断的灵敏度、准确度都高于血清PTH测定及B超检查结果,但特异性较低。^(99m)Tc-MIBI显像联合血清PTH测定及B超可以提高PHPT的诊断准确性,具有更高的临床应用价值。

Objective：To evaluate the clinical value of double phase 99mTc - MIBI imaging in the localization diagnosis of primary hyperparathyroidism（PHPT）. Methods： The results of 99mTC - MIBI imaging, serum PTH measurement and B ultrasound test in 57 patients with suspected PHPT were retrospectively analyzed . The postoperative pathology was used as the golden standard for PHPT. The sensitivities, specificities, accuracies of 99mTC -MIBI imaging, PTH measurement and B ultrasound test were compared and evaluated. Results ：All 57 cases with 99mTC -MIBI ima- ging results were compared with results of PTH measurement. The sensitivities, specificities, accuracies of 99roTe - MI- BI imaging and PTH measurement were 91.49% （80.85%）,50.00% （80.00%） ,84.42% （80.70%）. Meanwhile, 57 PHPT patients with 99roTe -MIBI imaging results were compared with results of B ultrasound test . All the imaging results were compared with surgery and pathology results. The sensitivities, specificities, accuracies were 91.49% （76.60 % ）, 50.00% （70.00%）, 84.21% （ 75.44 % ）. Conclusion ： The sensitivity and accuracy of double - phase 99mTC - MIBI imaging were significantly higher than that of B ultrasound and serum PTH, but the diagnostic specificity was lower. 99mTC - MIBI imaging combined with B ultrasound and serum PTH can increase diagnostic accuracy, has higher clinical value.