首都医科大学学报 ›› 2024, Vol. 45 ›› Issue (1): 31-35.doi: 10. 3969/ j. issn. 1006-7795. 2024. 01. 006

• 核医学与分子影像辅助临床诊疗 • 上一篇    下一篇

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

郭月红,黄京伟,张腾,杨敏福*   

  1. 首都医科大学附属北京朝阳医院核医学科,北京  100020
  • 收稿日期:2023-10-18 出版日期:2024-02-21 发布日期:2024-03-21
  • 通讯作者: 杨敏福 E-mail:minfuyang@ 126.com
  • 基金资助:
    北京市医院管理中心“扬帆”计划重点医学专业项目( ZYLX202105 )。

Factors associated with preoperative 99mTc-MIBI SPECT/CT in patients with suspected primary hyperparathyroidism

Guo Yuehong,Huang Jingwei,Zhang Teng,Yang Minfu*   

  1. Department of Nuclear Medicine,Beijing Chaoyang Hospital,Capital Medical University,Beijing 100020,China
  • Received:2023-10-18 Online:2024-02-21 Published:2024-03-21
  • Supported by:
    This study was supported by Beijing Hospitals Authority Clinical Medicine Development of Special Funding Support ( ZYLX202105 ).

摘要: 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99mTc -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。

关键词: 原发性甲状旁腺功能亢进症(PHPT), 99mTc-甲氧基异丁基异腈(MIBI), SPECT/CT

Abstract: Objective To explore the influencing factors of preoperative 99mTc-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. 

Key words: primary hyperparathyroidism (PHPT), 99mTc-methoxyisobutylisonitrile(MIBI), single-photon emission computed tomography/computed tomography(SPECT/CT)

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