摘要
目的:比较单光子发射型计算机断层显像/计算机断层扫描(single photon emission computed tomography/computed tomography,SPECT/CT)与99m锝-甲氧基异丁基异腈(99mTc-sestamibi,99mTc-MIBI)平面显像、超声、CT对甲状旁腺功能亢进(hyperparathyroidism,HPT)的诊断价值。方法:回顾性分析经手术治疗及病理学检查确诊的HPT患者59例,其中行SPECT/CT 31例,99mTc-MIBI平面显像28例,超声检查56例,CT检查26例,分别比较SPECT/CT与99mTcMIBI平面显像对HPT病灶定位、定性敏感性差异,以及SPECT/CT与99mTc-MIBI平面显像、超声、CT对HPT诊断准确性、敏感性、特异性差异。结果:SPECT/CT与99mTc-MIBI平面显像比较,病灶定位诊断敏感性差异无统计学意义(P>0.05),但增生病灶的定性诊断敏感性高于99mTc-MIBI平面显像(P<0.05);SPECT/CT与99mTc-MIBI平面显像、超声、CT比较,SPECT/CT对HPT诊断的准确性最高,与99mTc-MIBI平面显像比较差异有统计学意义(P<0.05),CT的敏感性最低,与SPECT/CT及超声的比较差异均有统计学意义(均P<0.05);当甲状旁腺病灶最大直径>1 cm时,SPECT/CT的敏感性最高(均P<0.05),而在直径<1 cm时,超声敏感性最高(均P<0.05)。结论:SPECT/CT较99mTc-MIBI平面显像对HPT(特别是增生性病灶)有更高的诊断价值;术前联合SPECT/CT与超声检查,可为甲状旁腺微创外科手术提供更为精准的解剖信息。
Objective:To compare the diagnostic value among the single photon emission computed tomography/computerized tomography(SPECT/CT),99mTc-sestamibi(MIBI) planar scintigraphy,ultrasonography(US) and computerized tomography(CT) in diagnosis of patients with hyperparathyroidism(HPT).Methods:A total of 59 patients were retrospectively recruited for this study.The patients received parathyroidectomy and were verified by pathological examination.Among them,31,28 and 26 patients received SPECT/CT,99mTc-MIBI planar scintigraphy,US and CT,respectively,before the parathyroidectomy.The sensitivity for localization or qualitation was compared between SPECT/CT and 99mTc-MIBI planar scintigraphy;the sensitivity,specificity and accuracy were compared among the SPECT/CT,^(99m)Tc-MIBI planar scintigraphy,US and CT.Results:There was no statistical difference in the sensitivity of localization between SPECT/CT and 99mTc-MIBI planar scintigraphy(P>0.05);however,the SPECT/CT exhibited more sensitive than the 99mTc-MIBI planar scintigraphy in detection of hyperplastic lesions(P<0.05).Among the four imaging modalities,SPECT/CT had advantages over 99mTc-MIBI planar scintigraphy in terms of accuracy(P<0.05).In contrast,the sensitivity of CT was not as good as that of SPECT/CT and US(both P<0.05).For the diagnosis of lesions with a diameter more than 1 cm,the sensitivity of SPECT/CT was the best(all P<0.05).However,the sensitivity of US was the best in diagnosis of lesions with a diameter less than 1 cm(all P<0.05).Conclusion:The SPECT/CT is more effective than 99mTc-MIBI planar scintigraphy in diagnosis of HPT,especially in diagnosis of hyperplastic lesions.Both of SPECT/CT and US are recommended to localize the target parathyroid lesions of HPT before the parathyroidectomy.
出处
《中南大学学报(医学版)》
CAS
CSCD
北大核心
2015年第9期1016-1022,共7页
Journal of Central South University :Medical Science