甲状旁腺病灶重量对^99Tc^m-MIBI显像诊断灵敏度的影响

The influence of parathyroid lesion weight on diagnostic sensitivity of^99Tc^m-MIBI imaging

目的探讨甲状旁腺病灶重量对^99Tc^m-甲氧基异丁基异腈(MIBI)双时相平面显像及其SPECT/CT早期断层融合显像诊断灵敏度的影响。方法收集2017年2月至2018年10月在昆山市第一人民医院经手术病理学确诊的甲状旁腺功能亢进患者22例,其中男性9例、女性13例,年龄28~73(50.77±8.79)岁。所有患者均于术前行^99Tc^m-MIBI双时相平面显像、^99Tc^m-MIBI SPECT/CT早期断层融合显像,以术后病理学结果为“金标准”。按切除的病灶重量将全部病灶分为两组,A组:病灶重量≤1.00 g,B组:病灶重量>1.00 g。采用χ^2检验分析两种显像方法对不同重量组的诊断效能。结果22例患者中,共切除病灶58个。^99Tc^m-MIBI双时相平面显像对A、B两组的诊断灵敏度分别为47.83%(11/23)和84.00%(21/25),差异有统计学意义(χ^2=7.05,P=0.008);^99Tc^m-MIBI SPECT/CT早期断层融合显像对A、B两组的诊断灵敏度分别为78.26%(18/23)和85.19%(23/27),差异无统计学意义(χ^2=0.40,P=0.525)。^99Tc^m-MIBI SPECT/CT早期断层融合显像对A组的诊断灵敏度高于^99Tc^m-MIBI双时相平面显像,差异有统计学意义(χ^2=4.57,P=0.033)。^99Tc^m-MIBI SPECT/CT早期断层融合显像对B组的诊断灵敏度高于^99Tc^m-MIBI双时相平面显像,但差异无统计学意义(χ^2=0.01,P=0.906)。结论甲状旁腺病灶重量对^99Tc^m-MIBI双时相平面显像诊断灵敏度有影响,当病灶重量较小时,^99Tc^m-MIBI双时相平面显像对其的诊断灵敏度较低;而病灶重量对^99Tc^m-MIBI SPECT/CT早期断层融合显像的诊断灵敏度无明显影响。

Objective To investigate the effect of parathyroid lesion weight on the diagnostic sensitivity of ^99Tc^m-MIBI dual-phase plane imaging and ^99Tc^m-MIBI SPECT/CT tomography fusion imaging.Methods A total of 22 patients with hyperparathyroidism that was confirmed via operation and pathology in the First People's Hospital of Kunshan were collected from February 2017 to October 2018.The patients included 9 males and 13 females aged 28–73(50.77±8.79)years old.All patients underwent ^99Tc^m-MIBI biphasic imaging and ^99Tc^m-MIBI SPECT/CT fusion imaging in the early stage.The gold standard was postoperative pathological results.All resected lesions were divided into two groups:group A,wherein lesion weight≤1.00 g,and group B,wherein lesion weight>1.00 g.χ^2 test was used to analyze the diagnostic efficacy of the two imaging methods in the different weight groups.Results A total of 58 lesions were removed from the 22 patients via surgical operation.The diagnostic sensitivity values of ^99Tc^m-MIBI dual-phase plane imaging for groups A and B were 47.83%(11/23)and 84.00%(21/25)respectively,and were statistically significantly different between the two groups(χ^2=7.05,P=0.008).The diagnostic sensitivity values of ^99Tc^m-MIBI SPECT/CT early tomography for groups A and B were 78.26%(18/23)and 85.19%(23/27),respectively,and did not show significant differences between the two groups(χ^2=0.40,P=0.525).In group A,the diagnostic sensitivity of ^99Tc^m-MIBI SPECT/CT early tomography was higher than that of dual-phase plane imaging;this difference was statistically significant(χ^2=4.57,P=0.033).In group B,the diagnostic sensitivity of ^99Tc^m-MIBI SPECT/CT early tomography was higher than that of dual-phase plane imaging;however,no significant difference was observed(χ^2=0.01,P=0.906).Conclusions The weight of parathyroid lesions has an effect on dual-phase planar imaging.Specifically,sensitivity decreased when the parathyroid glands were light.However,lesion weight had no significant effect on the diagnostic sensitivity of early tomographic fusion imaging.