99m Tc －MIBI 显像在原发性甲状旁腺功能亢进定位诊断中的应用价值

摘要

目的：评价99m Tc －甲氧基异丁基异腈（99m Tc －MIBI）显像在原发性甲状旁腺功能亢进症（PHPT）定位诊断中的临床应用价值。方法：回顾性分析57例疑似 PHPT 患者99m Tc －MIBI 显像、血清 PTH 测定及 B 超检查结果，以术后病理为金标准，对99m Tc －MIBI 双时相显像、血清 PTH 测定及 B 超检查三种诊断方法的灵敏度、特异度、准确度进行比较和评价。结果：术后病理证实，57例患者99m Tc －MIBI 显像与血清 PTH 测定两种诊断方法比较，灵敏度、特异度、准确度分别为91．49％（80．85％）、50．00％（80．00％）、84．42％（80．70％）；99m Tc －MIBI 显像与 B 超检查两种诊断方法比较，灵敏度、特异度、准确度分别为91．49％（76．60％）、50．00％（70．00％）、84．21％（75．44％）。结论：99m Tc －MIBI 显像对 PHPT 定位诊断的灵敏度、准确度都高于血清 PTH测定及 B 超检查结果，但特异性较低。99m Tc －MIBI 显像联合血清 PTH 测定及 B 超可以提高 PHPT 的诊断准确性，具有更高的临床应用价值。%Objective:To evaluate the clinical value of double phase 99m Tc -MIBI imaging in the localization diag-nosis of primary hyperparathyroidism(PHPT).Methods:The results of 99m Tc -MIBI imaging,serum PTH measure-ment and B ultrasound test in 57 patients with suspected PHPT were retrospectively analyzed .The postoperative pa-thology was used as the golden standard for PHPT.The sensitivities,specificities,accuracies of 99m Tc -MIBI imaging, PTH measurement and B ultrasound test were compared and evaluated.Results:All 57 cases with 99m Tc -MIBI ima-ging results were compared with results of PTH measurement.The sensitivities,specificities,accuracies of 99m Tc -MI-BI imaging and PTH measurement were 91.49%(80.85%),50.00%(80.00%),84.42%(80.70%).Meanwhile, 57 PHPT patients with 99m Tc -MIBI imaging results were compared with results of B ultrasound test .All the ima-ging results were compared with surgery and pathology results.The sensitivities,specificities,accuracies were 91.49%(76.60%),50.00%(70.00%),84.21%(75.44%).Conclusion:The sensitivity and accuracy of double -phase 99m Tc -MIBI imaging were significantly higher than that of B ultrasound and serum PTH,but the diagnostic specificity was lower.99m Tc -MIBI imaging combined with B ultrasound and serum PTH can increase diagnostic accuracy,has higher clinical value.