99mTc-MIBI显像定位诊断甲状旁腺功能亢进的临床价值

目的：评价＾９９ｍＴｃ－ＭＩＢＩ显像在定位诊断早状旁腺功能亢进中的价值。材料和方法：３０例临床诊断或高度怀疑甲旁亢患者于颈部及上胸部行＾９９ｍＴｃ－ＭＩＢＩ显像，采用双时相法（１５ｍｉｎ即刻相及１２０ｍｉｎ延迟相）并加做＾９９ｍＴｃ－ＭＩＢＩ全身显像，同期做Ｂ超（３０例）和ＣＴ检查（１０例）。结果：与手术病理结果对照，＾９９ｍＴｃ－ＭＩＢＩ显像、Ｂ超和ＣＴ诊断准确性分别为８３．３％、６３．３％和７０％，对于正常位置、异位、术后复发，＾９９ｍＴｃ－ＭＩＢＩ显像阳性检出率均较Ｂ超、ＣＴ高。结论：＾９９ｍＴｃ－ＭＩＢＩ显像在定位诊断甲状旁腺功能亢进疾患具有较高临床价值，万其对异位和术后复发及确定有无三发性甲旁亢的敏感性优于Ｂ超、ＣＴ，可作为甲状旁腺功能亢进症术前定位诊断的主要手段。

Clinical Value of the Localization of Hyperparathyroidism with 99m Tc - MIBI Imaging

Purpose: To evaluate the diagnostic values of 99m Tc - MIBI imaging in localizing of hyperparathyroidism. Moterials and Methods:99m Tc- MIBI double -phase imaging was performed on 30 patients withhyperparathyroidism or highly suspectable hyperparathyroidism for 15 main (early phase imaging) and 2 hours(delayed phase imaging) at neck and chest, followed by whole body imaging. Meanwhile all the patients had undergone ultrasound and 10 patients with CT. Results: In correlation with surgery and pathology, the accuracies of 99m Tc- MIBI imaging, ultrasound and CT were 83.3%、 63.3%and70%, respectively, Especially in the patients who have had normal position or ectopic hyperparathyroidism anrecurrent hyperparathyroidism, 99m Tc - MIBI imaging has higher positive rate than ultrasound and CT. Conclusions: There are significant clinical values of the localization of hyperparathyroidism with 99m Tc-MIBI imaging, especially in the ectopic, recurrent or tertiary hyperparathyroidism patients, so 99m Tc-MIBI imaging can be a useful method for the preoperative localization of hyperparathyroidism.