摘要
目的：探讨甲状旁腺功能亢进症（HPT）患者行99Tcm-MIBI与99TcmO4-联合显像对HPT病变的定位诊断价值。方法：原发性HPT患者36例，对照组10例为甲状腺疾病患者。99Tcm-MIBI注射后15min行早期相甲状旁腺显像，2h后行延迟显像。相隔24h后加做99TcmO4-甲状腺显像，对两种图像进行对比分析、视觉相减及图像判断。结果：36例HPT患者99Tcm-MIBI/99TcmO4-联合显像在甲旁腺部位或其邻近部位出现局限性核素明显增浓的阳性结果34例，假阴性结果2例，阳性率为94.44%；36例甲旁亢患者单行99Tcm-MIBI显像检出阳性结果12例，假阴性结果4例，可疑阳性结果20例，阳性率88.89%（其中55.56%为可疑阳性）。10例对照组单行99Tcm-MIBI显像出现假阳性结果3例，可疑假阳性结果1例，加做99TcmO4-显像后，对照组无假阳性结果。结论：99Tcm-MIBI/99TcmO4-联合显像可提高HPT病变诊断的阳性率，减少假阳性结果的发生，对单行99Tcm-MIBI显像出现可疑阳性结果者，联合显像有利于结果的准确判断，对甲状旁腺腺瘤的诊断与定位诊断有重要价值。
Abstract
Objective: To study the localization diagnostic value of nuclide imaging by 99Tcm-MIBI double phase parathyroid combined with 99TcmO4- thyroid imaging in patients with hyperparathyroidism(HPT). Methods: Thirty-six cases of primary HPT were included in this study. Control group included 10 cases with thyroid disease. Early phase imaging was performed in 15 minutes after injecting imaging agent 99Tcm-MIBI. Delay phase imaging was performed in 2 hours. Thirty-six HPT patients and 10 cases control group were also performed 99TcmO4- thyroid imaging 24 hours later. The two kinds of imaging were compared with each other, were analyzed, and were underwent imaging subtracted by eyes and imaging results judgement. Results: In 36 cases of HPT patients, 34 cases showed positive result imaging with 99Tcm-MIBI/99TcmO4- imaging. Two cases showed false negative result. Positive rate was 94.44% with 99Tcm-MIBI/99TcmO4- imaging. The positive result imaging showed abnormal increased uptake of 99Tcm-MIBI. In 36 cases of HPT patients, 12 cases showed positive result with single 99Tcm-MIBI imaging. Four cases showed false negative imaging. Twenty cases showed ambiguous positive results. Positive rate was 88.89%(55.56% was ambiguous positive results) with single 99Tcm-MIBI imaging. In 10 cases of control groups, 3 cases showed false positive results with single 99Tcm-MIBI imaging. One case showed ambiguous false positive results. No case showed false positive result with 99Tcm-MIBI/99TcmO4- imaging. Conclusion: 99Tcm-MIBI parathyroid double phase imaging combined with 99TcmO4- thyroid imaging have important value for diagnoses and localization of HPT. 99Tcm-MIBI/99TcmO4- imaging have higher positive rate and higher specificity than single 99Tcm-MIBI imaging for diagnoses and localization of hyperfunction parathyroid gland.
关键词
甲状旁腺功能亢进症 /
99m锝甲氧基异丁基异腈 /
放射性核素显像
Key words
Hyperparathyroidism /
Technetium tc 99m sestamibi /
Radionuclide imaging
张芬茹;许建林;周建平;施秉银;邓惠兴;段小艺.
99Tcm-MIBI与99TcmO4-联合显像对甲状旁腺功能亢进病变的定位诊断[J]. 中国临床医学影像杂志. 2009, 20(7): 519-522
ZHANG Fen-ru;XU Jian-lin;ZHOU Jian-ping;SHI Bing-yin;DENG Hui-xing;DUAN Xiao-yi.
Localization diagnosis of hyperfunctional parathyroid gland using 99Tcm-MIBI and 99TcmO4- imaging[J]. Journal of China Clinic Medical Imaging. 2009, 20(7): 519-522
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