疑诊原发性甲状旁腺功能亢进症的患者术前^(99m)Tc-MIBI SPECT/CT显像结果的影响因素分析

Factors associated with preoperative^(99m)Tc-MIBI SPECT/CT in patients with suspected primary hyperparathyroidism

目的探讨疑诊原发性甲状旁腺功能亢进症(primary hyperparathyroidism,PHPT)的患者术前^(99m)Tc-甲氧基异丁基异腈(methoxyisobutylisonitrile,MIBI)单光子发射计算机断层扫描/计算机断层扫描(single-photon emission computed tomography/computed tomography,SPECT/CT)(以下简称MIBI SPECT/CT)显像结果的影响因素。方法将2019年1月至2023年8月于首都医科大学附属北京朝阳医院疑诊PHPT并在术前完善甲状旁腺MIBI SPECT/CT显像的257例患者作为研究对象。比较MIBI SPECT/CT显像阳性组和阴性组的实验室检查、病理特征及影像特征。采用多因素Logistic回归分析MIBI SPECT/CT显像结果的影响因素。结果单因素分析显示,与阴性组相比,血清总钙、血清甲状旁腺激素(parathyroid hormone,PTH)、碱性磷酸酶(alkaline phosphatase,ALP)水平在阳性组显著升高(P<0.05);病灶的病理类型、最大径、体积及位置在两组间差异有统计学意义(P<0.05)。多因素Logistic回归分析显示,术前血清PTH水平、病灶病理类型、位置及最大径与MIBI SPECT/CT显像结果阳性显著相关(P<0.05)。结论疑诊PHPT患者术前MIBI SPECT/CT显像结果受多重因素影响,术前血清PTH水平、病灶病理类型、位置及最大径是MIBI SPECT/CT显像结果的独立影响因素。

Objective To explore the influencing factors of preoperative^(99m)Tc-MIBI single-photon emission computed tomography/computed tomography(SPECT/CT)in patients with suspected primary hyperparathyroidism(PHPT).Methods A total of 257 patients with suspected PHPT who underwent preoperative MIBI SPECT/CT from January 2019 to August 2023 were retrospectively reviewed.The laboratory examination,pathological features,and imaging features between the positive and negative MIBI SPECT/CT groups were compared to each other.Multivariate Logistic regression analysis was used to identify the influencing factors of MIBI SPECT/CT results.Results The serum total calcium,parathyroid hormone(PTH),and alkaline phosphatase(ALP)levels were significantly increased in the positive group than the negative group(P<0.05);The pathological type,maximum diameter,volume,and location of the lesion showed statistically significant differences between the two groups(P<0.05).Logistic regression analysis showed that preoperative serum PTH levels,pathological type,location,and maximum diameter of lesions were significantly correlated with positive MIBI SPECT/CT(P<0.05).Conclusion The preoperative MIBI SPECT/CT in patients with suspected PHPT were affected by multiple factors.The preoperative serum PTH level,pathological type,location and the maximum diameter of the lesion were independent factors for MIBI SPECT/CT.