^(99m)Tc-MIBI SPECT/CT显像在甲状旁腺功能亢进症的术前诊断价值

Preoperative diagnostic value of^(99m)T Tc-MIBI SPECT/CT imaging in hyperparathyroidism

目的:探讨^(99m)Tc-MIBI SPECT/CT显像、双时相平面显像及超声检查对甲状旁腺功能亢进症(HPT)的术前诊断价值。方法:纳入49例于我院诊断为HPT并行手术治疗的患者,以病理诊断为金标准,采用χ^(2)检验比较超声、双时相平面显像、^(99m)Tc-MIBI SPECT/CT显像及联合诊断HPT的灵敏度、特异度和准确度。结果:49例患者共96个甲状旁腺阳性病灶和7个非甲状旁腺病灶。^(99m)Tc-MIBI SPECT/CT显像术前定位诊断HPT的灵敏度和准确度分别为81.25%(78/96)、81.55%(84/103),其灵敏度和准确度均优于超声(灵敏度59.38%(57/96),χ^(2)=11.004,P=0.001;准确度61.17%(63/103),χ^(2)=10.475,P=0.001)、平面显像(灵敏度58.33%(56/96),χ^(2)=11.957,P=0.001;准确度57.28%(59/103),χ^(2)=14.291,P=0.000)。3种影像学方法对HPT诊断的特异度差异无统计学意义(P>0.05)。SPECT/CT显像联合超声诊断的灵敏度可提高至87.50%(84/96)。结论:^(99m)Tc-MIBI SPECT/CT显像术前定位诊断HPT的价值明显优于平面显像和超声检查,联合超声检查能提高灵敏度。

Objective:To evaluate the value of^(99m)T Tc-MIBI SPECT/CT imaging,dual-phase planar imaging and ultrasonography in preoperative diagnosis of hyperparathyroidism(HPT).Methods:Forty-nine patients diagnosed with HPT in our hospital and treated with surgery were included.Surgical pathological diagnosis served as the gold standard,the sensitivity,specificity,and accuracy of ultrasonography,dual-phase planar imaging,^(99m)T Tc-MIBI SPECT/CT imaging and combined diagnosis of HPT were compared usingχ^(2)test.Results:There were 96 parathyroid positive lesions and 7 false-positive lesions in 49 HPT pa-tients.The sensitivity and accuracy of^(99m)T Tc-MIBI SPECT/CT imaging was 81.25%(78/96)and 81.55%(84/103),respectively,which were significantly better than that of ultrasonography(sensitivity was 59.38%(57/96),χ^(2)=11.004,P=0.001;accuracy was 61.17%(63/103),χ^(2)=10.475,P=0.001),planar imaging(sensitivity was 58.33%(56/96),χ^(2)=11.957,P=0.001;accuracy was 57.28%(59/103),χ^(2)=14.291,P=0.000).There was no significant difference in the specificity of the three imaging methods in the diagnosis of HPT(P>0.05).The sensitivity of SPECT/CT imaging combined with ultrasonography was 87.50%(84/96).Conclusion:The value of^(99m)T Tc-MIBI SPECT/CT imaging in preoperative location diagnosis of HPT is significantly better than planar imag-ing and ultrasonography,and combined with ultrasonography can improve sensitivity.