^(99)Tc^(m)-MIBI SPECT/CT显像结合T/NT半定量分析对原发甲状旁腺腺瘤术前定位的价值

Value of ^(99)Tc^(m)-MIBI SPECT/CT imaging combined with T/NT semi-quantitative analysis for pre-operative localization of primary parathyroid adenoma

目的^(99)Tc^(m)-MIBI SPECT/CT显像结合T/NT半定量分析对原发甲状旁腺腺瘤术前定位的价值。方法回顾性分析我院术后诊断为原发甲状旁腺腺瘤81例患者的^(99)Tc^(m)-MIBI SPECT/CT显像及临床资料,结合T/NT半定量分析,探讨不同部位腺瘤的检出率。结果^(99)Tc^(m)-MIBI SPECT/CT断层显像、平面显像对腺瘤检出率分别为95.7%(67/70)、90%(63/70);^(99)Tc^(m)-MIBI SPECT/CT断层和平面显像腺瘤检出率差异无统计学意义(χ^(2)=1.723,P=0.189)。根据腺瘤的位置将腺瘤分为上侧和下侧。^(99)Tc^(m)-MIBI SPECT/CT断层显像、平面显像对上侧腺瘤检出率分别为92.8%(13/14)、85.7%(12/14),对下侧腺瘤检出率分别为100%(53/53)、100%(53/53)。^(99)Tc^(m)-MIBI SPECT/CT断层显像上下侧腺瘤检出率差异无统计学意义(χ^(2)=3.84,P=0.20),^(99)Tc^(m)-MIBI SPECT/CT平面显像下侧腺瘤检出率高于上侧(χ^(2)=7.80,P=0.04)。下侧腺瘤体积大于上侧(Z=-3.19,P=0.001),腺瘤体积和早期相T/NT比值及血清甲状旁腺激素具有弱相关性(r=0.475、0.329,P<0.05)。结论通过对原发甲状旁腺瘤患者行术前^(99)Tc^(m)-MIBI SPECT/CT显像,并结合T/NT半定量分析,提高了不同部位腺瘤定位的准确度,能够为手术提供有价值的参考。

Objective To investigate the value of ^(99)Tc^(m)-MIBI SPECT/CT imaging combined with T/NT semi-quantitative analysis in pre-operative of primary parathyroid adenoma.Methods The ^(99)Tc^(m)-MIBI SPECT/CT imaging and clinical data of 81 patients diagnosed with primary parathyroid adenoma were retrospectively analyze,to investigate the detection rate of parathyroid adenoma in different sites.Results The detection rate of ^(99)Tc^(m)-MIBI SPECT/CT tomography imaging,^(99)Tc^(m)-MIBI SPECT/CT planar imaging were 95.7%(67/70) and 90%(63/70),respectively.There was no significant difference in detection rate between99Tc^(m)-MIBI SPECT/CT tomography imaging and planar imaging(χ^(2)-1.723,P=0.189).Adenomas are classified as superior and inferior according to their location,the detection rate of99Tc^(m)-MIBI SPECT/CT tomography imaging,99Tc^(m)-MIBI SPECT/CT planar imaging for superior adenomas were 92.8%(13/14)and 85.7%(12/14), and for inferior adenomas were 100%(53/53) and100%(53/53) respectively.There was no significant difference in detection rate of adenomas between the upper and lower sides on99Tc^(m)-MIBI SPECT/CT tomography imaging(χ^(2)=3.84,P=0.20).The detection rate of inferior adenomas in99Tc^(m)-MIBI SPECT/CT planar imaging was higher on the lower side than on the upper side(χ^(2)=7.80,P=0.04).Adenoma volume on the inferior side was greater than on the superior side(Z=-3.19,P=0.001),and there was a weak correlation between adenoma volume and early phase T/NT ratio and serum parathyroid hormone(r=0.475,0.329,P<0.05).Conclusion By performing preoperation99Tc^(m)-MIBI SPECT/CT imaging in patients with primary parathyroid adenoma combined with T/NT semi-quantitative analysis,the accuracy of adenoma localization at different sites is improved and could provide a valuable reference for surgery.