Tc-99m-MIBI双时相显像评价甲状旁腺机能亢进症的临床研究

Clinical study of hyperparathyroidism by using Tc-99m-MIBI double-phase imaging

目的:在甲状旁腺机能亢进症患者中,评价双时相Tc-99m-MIBI甲状旁腺显像对异常甲状旁腺组织的诊断和定位。方法:35例临床检查和生化指标提示甲状旁腺机能亢进的患者,手术前1周内行双时相Tc-99m-MIBI甲状旁腺平面显像。注射740MBq的Tc-99m-MIBI,15分钟和2小时后,分别进行颈胸前位平面显像,部分病人在延迟相还进行SPECT断层显像。结果:Tc-99m-MIBI甲状旁腺显像结果与手术结果对比,双时相Tc-99m-MIBI甲状旁腺平面显像对甲状旁腺腺瘤诊断灵敏度是75%(27?36),而SPECT断层显像的灵敏度是86%(31?36);甲状旁腺增生诊断灵敏度是50%(2?4)。结论:本研究认为双时相Tc-99m-MIBI甲状旁腺显像对甲状旁腺腺瘤的诊断和定位有较高的临床价值,尤其是SPECT断层显像,而对甲状旁腺增生的诊断,有必要进行进一步研究。

Objective:To evaluate the clinical value of the Tc-99m-MIBI double-phase imaging in patients with hyper-parathyroidism.Methods:In35patients with hyperparathyroidism proven by physical examination and biochemical blood tests,the Tc-99m-MIBI double-phase imaging was performed at early(15min)and late(2hours)phase.Cervical-thoracic planar im-ages were acquired.In some patients,late phase SPECT imaging was also performed.Results:Comparing the imaging results with that of histopathology,the diagnostic sensitivities of planar and SPECT imaging were75%and86%respectively in pa-tients with parathyroid adenomas,but in patients with parathyroid hyperplasia,the diagnostic sensitivity was only50%.Con clu-sions:This study indicated the Tc-99m-MIBI double-phase imaging is an effective tool in diagnosis and localization of parathyroid adenomas,particularly in SPECT imaging.But further study is required in the diagnosis of parathyroid hyperplasia.