99mTc-MIBI SPECT/CT诊断原发性甲状旁腺功能亢进症

目的 探讨SPECT/CT同机融合技术在99mTc-MIBI核素显像诊断原发性甲状旁腺功能亢进症(PHPT)中的价值.方法 于患者静脉注射99mTc-MIBI 370～740 MBq后行颈胸部的即刻和40 min延迟的双时相静态平面采集;注药后20 min行同部位的SPECT/CT采集,评价常规SPECT显像断层采集提供信息是否明显优于平面采集,SPECT/CT显像提供信息是否明显优于平面采集和常规SPECT显像断层采集,并对血清生物化学指标进行相关性统计学分析.结果 与术后病理诊断比较,平面采集加SPECT与平面采集加SPECT/CT诊断甲状旁腺病变符合率为86.96%,多结节腺体符合率为100%,总符合率为91.30%.SPECT/CT显像使1例阴性诊断改为阳性,并为3例患者提供更确切的腺体定位.SPECT/CT在2例异位甲状旁腺腺瘤定位诊断中显示出较为显著的优势.各血生化指标与显像结果 无相关性.结论 SPECT/CT同机融合技术在异位PHPT定位诊断上有较高的应用价值.

99mTc-MIBI SPECT/CT diagnosis of primary hyperparathyroidism

Objective To assess the value of SPECT/CT in diagnosing primary hyperparathyroidism (PHPT) with ^99mTc-MIBI. Methods Dual-phase static planar acquisitions of the neck and chest after intravenous injection of 370-740 MBq of ^99mTc-MIBI were performed immediately and 40 min later. SPECT/CT images were acquired 20 min after injection. Two experienced doctors independently interpreted the images and assessed whether the conventional SPECT would provide more information than planar images, and whether SPECT/CT was superior to planar images and conventional SPECT images. Biochemical markers of serum were also analyzed statistically. Results Compared with pathological results, the coincidence rate of planar imaging plus SPECT and planar imaging plus SPECT/CT to identify the diseased parathyroid gland was 86.96% in normal thyroid glands and 100% in multinodular glands, with a total coincidence of 91.30%. With the help of SPECT/CT, 1 case was changed from positive to negative and 3 cases were better located. SPECT/CT was obviously helpful in locating two ectopic parathyroid adenomas. No significant correlation was found between biochemical markers and image findings. Conclusion SPECT/CT has significant clinical value in locating lesions of PHPT.