99Tcm-MIBI SPECT/CT显像在原发性甲状旁腺功能亢进症诊断中的价值讨论

目的 探讨⁹⁹Tc^m-MIBI SPECT/CT显像在原发性甲状旁腺功能亢进症（PHPT）中的诊断价值。方法 回顾性分析为诊断PHPT而行⁹⁹Tc^m-MIBI SPECT/CT显像检查的57例患者的临床资料，以术后病理诊断为金标准，与高频超声、CT结果对比，分别统计三种检查方法的灵敏度、特异度、诊断符合率，将三种检查方法的灵敏度、特异度、诊断符合率加以对比分析。结果 57例病人经手术及病理检查共确诊76个PHPT病灶。⁹⁹Tc^m-MIBI SPECT/CT显像、高频超声、CT敏感度分别为75%、69.73%、50.94%；特异度分别为93.75%、96.07%、95.08%；诊断符合率分别为83.57%、80.31%、74.56%。⁹⁹Tc^m-MIBI SPECT/CT显像敏感度、诊断符合率高于CT （P<0.05），⁹⁹Tc^m-MIBI SPECT/CT显像对异位PHPT病灶诊断的敏感度为100%。结论 ⁹⁹Tc^m-MIBI SPECT/CT显像在PHPT病灶的定位中有较高的价值，是术前定位的较好方法。

Discussion on the value of 99Tcm-MIBI single photon emission computed tomography/computerized tomography in the diagnosis of primary hyperparathyroidism

Objective To evaluate the clinical value of ⁹⁹Tc^m-MIBI SPECT/CT in diagnosis of primary hyperparathyroidism (PHPT).Methods Clinical data of 57 patients who underwent ⁹⁹Tc^m -MIBI SPECT/CT for the diagnosis of PHPT were retrospectively analyzed, postoperative pathological diagnosis was taken as the gold standard, and the results were compared with high frequency ultrasound and CT, in the respects of sensitivity, specificity and diagnostic coincidence rate.Results A total of 76 PHPT lesions were diagnosed by operation and pathology in 57 patients. The sensitivities of ⁹⁹Tc^m -MIBI SPECT/CT, high frequency ultrasound and CT were 75%, 69.73% and 50.94%.The specificities were 93.75%, 96.07% and 95.08%.The diagnostic coincidence rates were 83.57%, 80.31% and 74.56%. The sensitivity and diagnostic coincidence rate of ⁹⁹Tc^m -MIBI SPECT/CT were higher than CT(P<0.05),and the sensitivity of⁹⁹Tc^m -MIBI SPECT/CT to the diagnosis of ectopic PHPT lesion was 100%.Conclusion ⁹⁹Tc^m -MIBI SPECT/CT has a high value in the localization of PHPT lesions and is a good method for preoperative localization.