首都医科大学学报 ›› 2008, Vol. 29 ›› Issue (1): 23-25.

• 专题报道 • 上一篇    下一篇

99mTc-MIBI双时相法诊断甲状旁腺功能亢进症的临床价值

唐玲1, 马云川2, 王荣福3, 付占立3, 范岩3   

  1. 1. 首都医科大学附属复兴医院核医学科;2. 首都医科大学附属宣武医院PET中心;3. 北京大学医学院附属第一医院 核医学科
  • 收稿日期:2007-11-18 修回日期:1900-01-01 出版日期:2008-02-24 发布日期:2013-07-15
  • 通讯作者: 唐玲

Clinical Value of Double-phase 99mTc-MIBI Scintigraphy in the Diagnosis of Hyperparathyroidism

Tang Ling1, Ma Yunchuan2, Wang Rongfu3, Fu Zhanli3, Fan Yan3   

  1. 1. Department of Nuclear Medical, Fuxing Hospital, Capital Medical University;2. Department of PET Center, Xuanwu Hospital, Capital Medical University;3. Department of Nuclear Medical, The First Hospital of Beijing University
  • Received:2007-11-18 Revised:1900-01-01 Online:2008-02-24 Published:2013-07-15

摘要: 目的 探讨核素99mTc-甲氧基异丁基异腈(99mTc-MIBI)双时相法显像在诊断甲状旁腺功能亢进症(hyper-parathyroidism,HPT)中的作用,并与其他影像检查方法进行比较.方法 65例临床考虑为HPT的患者均分别进行了核素显像及超声检查, 20例做了CT检查,11例做了MRI检查. 核素显像采用99mTc-MIBI双时相法.比较几种影像检查的灵敏度、特异性,分析其对HPT的诊断价值.结果 65例患者中,甲状旁腺激素(PTH)增高36例,以PTH结果为诊断标准.核素检查阳性34例,阴性2例,灵敏度94.4%,特异性100%,准确性96.9%;超声检出32例,阴性4例,假阳性2例,其灵敏度88.9%,特异性93.1%,准确性90.8%;CT阳性17例,MRI阳性8例.结论 核素99mTc-MIBI双时相法甲状旁腺显像是一种简便有效的检查方法,可提高甲状旁腺瘤术前定位诊断的准确率.临床高度怀疑原发性甲状旁腺功能亢进症的病人,若超声检查阴性应进一步行核素检查除外甲状旁腺瘤.

关键词: 甲状旁腺功能亢进, 核素显像, 超声, CT

Abstract: Objective To compare double phase 99mTc-MIBI imaging with ultra-sound,CT and MRI in the diagnosis of hyperparathyroidism.Methods Sixty-five patients with clinical diagnosis of hyperparathyroidism were injected intravenously with 370 MBq(10 mCi) of 99mTc-MIBI,and imaged 15 min later as early phase imaging and 120 min later as delayed phase imaging respectively.All patients under went B ultra-sound examination;20 and 11 patients underwent CT and MRI,respectively.Results Thirty-six cases among 65 patients showed high level of parathyroid homone(PTH),which was considered as diagnostic criterion for hyperparathyroidism.Among these,34 showed positive radionuclide parathyroid images,with the sensitivity,specificity and accuracy of 94.4%,100% and 96.9%,respectively.Thirty-two patients showed abnormal ultra-sound results,and the sensitivity,specificity and accuracy were 88.9%,93.1% and 90.8%,respectively.Seventeen CT images and 8 MR images showed positive results,respectively.Thirty-five adenomas and 1 histo-pathologically proved hyperplastic gland were removed from 34 patients.Conclusion Double phase 99mTc-MIBI imaging is a kind of useful and reliable approach for localization of parathyroid adenomas.Combined with other examinations,double phase 99mTc-MIBI imaging can improve the accuracy of diagnosis of the parathyroid lesions before surgery.

Key words: hyperparathyroidism, radionuclide imaging, ultra-sound, computed tomography

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