放射性核素显像在原发性甲状旁腺功能亢进诊治中的应用

目的探讨放射性核素99mTcsestemibi双时相显像在原发性甲状旁腺功能亢进病人术前诊断、定位及术中辅助识别切除甲状旁腺瘤的应用价值。方法1993年3月至2004年3月,对7例原发性甲状旁腺功能亢进病人术前行99mTcsestemibi双时相核素显像;对其中2例甲状旁腺瘤病人术中应用Tcsestemibi核素进行辅助识别,切除后冰冻切片检查明确诊断,并对其疗效进行随访。结果7例均手术,共发现8个甲状旁腺病灶,病理检查证实甲状旁腺腺瘤6例,甲状旁腺瘤伴甲状旁腺增生1例。2例术中应用99mTcsestemib核素辅助识别甲状旁腺瘤,均顺利寻及甲状旁腺瘤,术中冰冻切片证实。所有病人恢复良好,无并发症出现,随访1～5年,临床症状无复发,疗效满意。结论原发性甲状旁腺功能亢进双时相核素显像可明确甲状旁腺瘤的诊断,便于手术定位。放射性核素术中辅助识别甲状旁腺瘤简化了手术操作、缩短手术时间、避免了不必要的手术探查及术后并发症的发生。

The appliance value of the radionuclide in the diagnosis and treatment of primary hyperparathyroidism

Objective To investigate the appliance value of the radionuclide in the diagnosis and treatment of primary hyperparathyroidism.Methods Seven patients with primary hyperparathyroidism were made radionuclide delay image by ~ 99mTc-sestemibi.Two of them were used~ 99mTc-sestemibi as mark to discriminate the parathyroidoma during the operation,frozen section pathological examination was used to determine the diagnosis post parathyroidoma excision.Results Eight leision tissues were found in these patients,6 cases of them were parathyroidoma,and 1 case was parathyroidoma company with parathyroid hyperplasia,2 patients with parathyroidoma were found the leision bite by way of ~ 99mTc-sestemibi as mark during operation.Parapthyroma was proved by pathological examination of frozen section.All patients got a better prognosis,no complication had been found all of them.Follow up from 1 year to 5 years,the clinic symptom of hyperparathyroidism had no recurrence in these patients of this group,and satisfying effect had been acquired.Conclusion Parathyroid delay image of ~ 99m Tc-sestemibi could make the location of primary parathyroidma so as to determine the place of parathyroidma during operation.~ 99m Tc-sestemibi assistance discriminate the parathyoidoma could make the operative administration easy,short the operative time,avoid the unnecessary operative wound and post operative complication.