^(99m)Tc-MIBI甲状旁腺显像阴性的原发性甲状旁腺功能亢进症:1例报告

Primary hyperparathyroidism with negative^(99m)Tc-MIBI imaging:one case report

本文报道1例原发性甲状旁腺功能亢进症(primary hyperparathyroidism,PHPT)合并维生素D缺乏患者的诊治过程,旨在为PHPT术前定位诊断提供借鉴。患者为青年男性,起病隐匿,多次检验均显示有高钙血症、低磷血症、高钙尿症及高甲状旁腺素血症,无肾功能不全,PHPT诊断明确,同时合并双肾结石、维生素D缺乏。患者符合手术指征,但术前定位的难点在于:超声检查提示双侧甲状旁腺区均有可疑占位,^(99m)Tc-MIBI显像结果阴性。通过^(18)F-氟代胆碱PET/CT实现术前精准定位,患者术后痊愈。

This article reports the diagnosis and treatment of a patient with primary hyperparathyroidism(PHPT)and vitamin D deficiency.The patient was a young male with a insidious onset.Multiple tests have shown hypercalcemia,hypophosphatemia,hypercalciuria,and hyperparathyroidism.There was no renal dysfunction,and the diagnosis of PHPT was clear.There were kidney stones and vitamin D deficiency at the same time.The patient met the surgical indications,but the difficulty in preoperative localization was that ultrasound examination showed suspicious masses in both parathyroid regions,and the^(99m)Tc-MIBI imaging result was negative.Finally,accurate preoperative localization was achieved through^(18)F-fluorocholine PET/CT,and the patient was cured after surgery.