99Tcm-MIBI SPECT/CT断层融合显像在甲状旁腺功能亢进中的诊断价值

Clinical value of 99Tcm-MIBI SPECT/CT in the diagnosis of hyperparathyroidism

目的探讨99m锝-甲氧基异丁基异腈单光子发射型计算机断层显像/计算机断层扫描(99Tcm-MIBI SPECT/CT)断层融合显像在诊断甲状旁腺功能亢进中的临床意义,探讨不同时相断层显像的诊断意义并与99Tcm-MIBI双时相平面显像对比。方法54例甲状旁腺功能亢进患者均行99Tcm-MIBI双时相平面显像、99Tcm-MIBI SPECT/CT早期断层融合显像、延迟断层融合显像检查。根据临床诊断标准,分析三种显像方法诊断甲状旁腺功能亢进及病灶的灵敏度。结果99Tcm-MIBI双时相平面显像诊断灵敏度为75.9%(41/54),99Tcm-MIBI SPECT/CT早期断层融合显像诊断灵敏度为88.9%(48/54),99Tcm-MIBI SPECT/CT延迟断层融合显像诊断灵敏度为77.8%(42/54);99Tcm-MIBI双时相平面显像诊断病灶74个,99Tcm-MIBI SPECT/CT早期断层融合显像诊断病灶95个,99Tcm-MIBI SPECT/CT延迟断层融合显像诊断病灶78个。早期断层融合显像阳性病灶检出率较高;早期断层融合显像诊断出4例异位甲状旁腺病灶,双时相平面显像及延迟断层融合显像均诊断出3例。结论99Tcm-MIBI SPECT/CT是定位甲状旁腺功能亢进病灶的有效方法,尤其是早期断层融合显像,结合患者血清甲状旁腺激素值,可以提高其诊断效能。

Objective To evaluate the clinical value of99Tcm-sestamibi( MIBI) single photon emission computed tomography/computerized tomography(99Tcm-MIBI SPECT/CT) imaging in hyperparathyroidism( HPT),and to investigate the diagnostic significance of different phase tomographic imaging and compare with99Tcm-MIBI dual phase plane imaging. Methods All 54 patients underwent99Tcm-MIBI dual-phase planar imaging,99Tcm-MIBI SPECT/CT early tomographic fusion imaging,delayed tomographic fusion imaging. According to the clinical diagnostic criteria,the sensitivity of three imaging methods in the diagnosis of hyperparathyroidism and the lesions was analyzed. Results ⑴ The diagnostic sensitivity of the99Tcm-MIBI dual-phase planar imaging was 75. 9%( 41/54). The diagnostic sensitivity of the99Tcm-MIBI SPECT/CT early tomographic fusion imaging was 88. 9%( 48/54). The diagnostic sensitivity of99Tcm-MIBI SPECT/CT delayed tomographic fusion imaging was 77. 8%( 42/54) . ⑵ There were 74 lesions diagnosed by99Tcm-MIBI dual phase planar imaging,95 lesions diagnosed by99Tcm-MIBI SPECT/CT early stage fusion imaging,and 78 lesions diagnosed by99Tcm-MIBI SPECT/CT delayed fusion imaging. The detection rate of positive lesions in early stage tomography was the highest. ⑶ There were 4 cases of ectopic parathyroid lesions diagnosed by early CT fusion imaging,3 cases by dual phase planar imaging and delayed CT fusion imaging. Conclusions99Tcm-MIBI SPECT/CT is an effective method to locate the focus of HPT,especially early tomographic fusion imaging combined with serum parathyroid hormone( PTH) value can improve the diagnostic efficiency.