上海交通大学学报（医学版）

上海交通大学学报（医学版）

• 论著（临床研究） • 上一篇    下一篇

99mTc-MIBI SPECT/CT与B超在甲状旁腺功能亢进症中的诊断价值比较

徐莲 1，孙晓光 1，刘建军 1，周明舸 1，江舟 2   

  1. 上海交通大学医学院附属仁济医院 1. 核医学科，2. 病理科，上海 200127
  • 出版日期:2017-04-28 发布日期:2017-05-04
  • 通讯作者: 孙晓光，电子信箱：xgsun@vip.sina.com。
  • 作者简介:徐莲（1984—），女，住院医师，硕士；电子信箱：xulian2004@126.com。
  • 基金资助:

     国家自然科学基金（81530053）

Comparison of 99mTc-MIBI SPECT/CT and ultrasonography in diagnosis of hyperparathyroidism

XU Lian1, SUN Xiao-guang1, LIU Jian-jun1, ZHOU Ming-ge1, JIANG Zhou2   

  1. 1. Department of Nuclear Medicine, 2. Department of Pathology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China
  • Online:2017-04-28 Published:2017-05-04
  • Supported by:

    National Natural Science Foundation of China, 81530053

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摘要：

目的 ·探讨99m锝-甲氧基异丁基异腈（99mTc-MIBI）单光子发射型计算机断层显像/计算机断层扫描（SPECT/CT）在甲状旁腺功能亢进症中的诊断价值及其与
B超诊断效能的比较。方法 ·纳入50例诊断为甲状旁腺功能亢进症并手术治疗的患者，术前行99mTc-MIBI SPECT/CT，其中33例同时行B超检查。以手术病理结果为金标准，比较2种检查方法的诊断效能。结果 ·原发性和继发性甲状旁腺功能亢进症患者血清甲状旁腺激素（PTH）质量浓度分别为352.0（141.5～846.0）pg/mL和1 792.0（1 018.5～2 358.5）pg/mL，病灶最大径分别为14.5（9.0～20.9）mm和10.0（8.0～12.6）mm，诊断准确度分别为97.7%和62.5%，差异均有统计学意义（均P<0.01）。33例患者99mTc-MIBI SPECT/CT的诊断灵敏度为66.3%、准确度为74.2%，B超的灵敏度为45.7%、准确度为61.4%；2种检查方法灵敏度和准确度的差异均有统计学意义（均P<0.05）。结论 ·原发性甲状旁腺功能亢进症与继发性甲状旁腺功能亢进症比较，血清PTH水平低，病灶大，诊断效能高。99mTc-MIBI SPECT/CT显像的诊断灵敏度及准确度均高于B超。

关键词: 99m锝-甲氧基异丁基异腈, 单光子发射型计算机断层显像/计算机断层扫描, B超, 甲状旁腺功能亢进症, 甲状旁腺激素

Abstract:

Objective · To explore the diagnostic value of 99mTc-sestamibi (99mTc-MIBI) single photon emission computed tomography/computed tomography (SPECT/CT) and ultrasonography in hyperparathyroidism. Methods · Fifty patients with hyperparathyroidism were included. 99mTc-MIBI SPECT/CT was performed before operations in all patients, while ultrasonography was performed in 33 patients. The diagnostic efficiency was calculated for both imaging methods in comparison to pathological data. Results · Serum parathyroid hormone (PTH) levels were 352.0 (141.5–846.0) pg/mL and 1 792.0 (1 018.5–2 358.5) pg/mL, respectively, in primary hyperparathyroidism (PHPT) and secondary hyperparathyroidism (SHPT), while maximum diameters of lesion were 14.5 (9.0–20.9) mm and 10.0 (8.0–12.6) mm, respectively (both P<0.01). The accuracy of SPECT/CT were 97.7% and 62.5%, respectively (P<0.01), in PHPT and SHPT. In 33 patients, the sensitivity and accuracy of SPECT/CT were 66.3% and 74.2%, respectively, whereas the sensitivity and accuracy of ultrasonography were 45.7% and 61.4%, respectively (both P<0.05). Conclusion · Serum PTH levels were higher, while maximum diameters of lesion were longer in PHPT than that in SHPT, and the diagnostic efficiency was also higher in PHPT than that in SHPT. In the other hand, the sensitivity and accuracy of SPECT/CT were higher than that of ultrasonography.

Key words: 99mTc-sestamibi, single photon emission computed tomography/computed tomography, ultrasonography, hyperparathyroidism, parathyroid hormone