99mTc-MIBI双时相显像诊断甲状旁腺功能亢进的临床价值

目的:评价99mTc-MIBI双时相显像在甲状旁腺功能亢进症(甲旁亢)诊断中的临床价值。方法:44例拟诊甲旁亢患者进行了99mTc-MIBI双时相显像。阳性指标为延迟图像上出现异常增高的放射性聚集,显像资料均参照临床最终诊断结果进行评价,并与同期的B超或CT检查作了对比分析。结果:44例患者中,33例确诊为甲旁亢,其中甲状旁腺腺瘤31例(包括异位1例)、甲状旁腺增生1例与甲状旁腺癌1例。诊断灵敏度为90.9%,特异度为100%,准确性为93.2%,同期B超诊断灵敏度和准确性为70%与77.3%。另25例患者有CT资料,12例有阳性发现(60%)。99mTc-MIBI双时相显像在甲旁亢的诊断中具有较高的阳性率,在腺瘤诊断方面较B超和CT具有更高的诊断效能(P<0.05)。结论:99mTc-MIBI双时相显像能较准确的检测功能亢进的甲状旁腺,是患者术前定位的重要辅助诊断手段,值得临床推广应用。

Clinical value of double phase 99mTc-MIBI imaging in diagnosing hyperparathyroidism

Objective: To evaluate the clinical value of double phase 99mTc-MIBI imaging in diagnosing hyperparathyroidism. Methods: Forty-four patients with highly suspected hyperparathyroidism underwent double phase 99mTc-MIBI imaging. Abnormal increase radioactivity in delay imaging stood for positive index. Imaging material were evaluated according to final clinical results and compared with ultrasound or CT. Results: In 44 patients, 33 hyperparathyroidism were proven, including 31 adenomas(ectopic 1), 1 hyperplasia and 1 carcinoma. The sensitivity and specificity of diagnosis were 90.9%, 100%, respectively. The accuracy of double phase 99mTc-MIBI imaging was 93.2%. The sensitivity and specificity of ultrasound were 70%, 77.3%, respectively. The sensitivity of CT was 60%. The results showed that double phase 99mTc-MIBI imaging was superior to ultrasound and CT(P<0.05). Conclusion: Double phase 99mTc-MIBI imaging could accurately diagnose hyperparathyroidism. It is an important localizing method for preoperation which is worthy of generating.