99Tcm-MIBI SPECT/CT显像在原发性甲状旁腺功能亢进症诊断中的价值讨论

Discussion on the value of 99Tcm -MIBI single photon emission computed tomography/computerized tomography in the diagnosis of primary hyperparathyroidism

目的探讨99Tcm-MIBI SPECT/CT显像在原发性甲状旁腺功能亢进症(PHPT)中的诊断价值。方法回顾性分析为诊断PHPT而行99Tc^m-MIBI SPECT/CT显像检查的57例患者的临床资料,以术后病理诊断为金标准,与高频超声、CT结果对比,分别统计三种检查方法的灵敏度、特异度、诊断符合率,将三种检查方法的灵敏度、特异度、诊断符合率加以对比分析。结果 57例病人经手术及病理检查共确诊76个PHPT病灶。99Tc^m-MIBI SPECT/CT显像、高频超声、CT敏感度分别为75%、69.73%、50.94%;特异度分别为93.75%、96.07%、95.08%;诊断符合率分别为83.57%、80.31%、74.56%。99Tc^m-MIBI SPECT/CT显像敏感度、诊断符合率高于CT (P<0.05),99Tc^m-MIBI SPECT/CT显像对异位PHPT病灶诊断的敏感度为100%。结论 99Tc^m-MIBI SPECT/CT显像在PHPT病灶的定位中有较高的价值,是术前定位的较好方法。

Objective To evaluate the clinical value of 99Tc^m,-MIBI SPECT/CT in diagnosis of primary hyperparathyroidism (PHPT). Methods Clinical data of 57 patients who underwent 99Tc^m-MIBI SPECT/CT for the diagnosis of PHPT were retrospectively analyzed, postoperative pathological diagnosis was taken as the gold standard , and the results were compared with high frequency ultrasound and CT, in the respects of sensitivity, specificity and diagnostic coincidence rate. Results A total of 76 PHPT lesions were diagnosed by operation and pathology in 57 patients. The sensitivities of 99Tc^m-MIBI SPECT/CT, high frequency ultrasound and CT were 75%,69.73% and 50.94%.The specificities were 93. 75%, 96. 07% and 95. 08%. The diagnostic coincidence rates were 83.57%,80.31% and 74.56%. The sensitivity and diagnostic coincidence rate of 99Tc^m-MIBI SPECT/CT were higher than CT(P<0.05), and the sensitivity of 99Tc^m-MIBI SPECT/CT to the diagnosis of ectopic PHPT lesion was 100%. Conclusion 99Tc^m-MIBI SPECT/CT has a high value in the localization of PHPT lesions and is a good method for preoperative localization.