早期SPECT/CT对甲状旁腺功能亢进症术前定位的增益价值

摘要

目的:探讨99mTc-MIBI双时相平面显像及早期SPECT/CT断层融合显像对单发及多发性甲状旁腺功能亢进症病灶术前定位的诊断价值.方法:回顾性分析2011年6月至2016年6月间42例(男20例,女22例,年龄53.1±14.8岁)临床诊断为原发或继发性甲状旁腺功能亢进症且获得手术病理结果的患者资料,所有患者均行99mTc-MIBI双时相甲状旁腺平面显像及早期SPECT/CT断层融合显像进行术前定位.以手术病理结果为金标准,分别评价平面显像及早期SPECT/CT断层融合显像对单发及多发性甲状旁腺功能亢进症病灶的诊断效能.结果:42例患者术中共探得甲状旁腺阳性病灶78个,早期SPECT/CT对单发及多发病灶的诊断准确性均显著高于双期平面像,差异有统计学意义(x2=9.195,P＜0.05;x2=9.001,P＜0.05).结论:增加早期SPECT/CT对甲状旁腺功能亢进症术前定位较传统双时相平面显像有较高的增益价值.%Purpose:To evaluate the preoperative localization value of dual-phase 99Tcm-MIBI planar imaging with or without early-phase SPECT/CT in the preoperative localization of parathyroid lesions.Methods:Fortytwo patients (20 males,22 females;mean age 53.1±14.8 years) with primary or secondary hyperparathyroidism who had been undergone parathyroidectomy from June 2011 to June 2016 were analyzed retrospectively.All patients underwent dual-phase 99Tcm-MIBI planar scan and early-phase SPECT/CT scan.Single gland and multi-gland disease of hyperparathyroidism were evaluated by these two imaging groups respectively.The diagnostic efficiencies were calculated according to the pathological results.Results:Seventy-eight abnormal parathyroid lesions were found in 42 patients.The diagnostic accuracy of early-phase SPECT/CT were significantly higher than that of dual-phase planar imaging both for single gland disease and multi-gland disease (x2 =9.195,P＜0.05;x2 =9.001,P＜0.05).Conclusion:The early-phase SPECT/CT imaging has preferable diagnostic value in the preoperative localization of hyperparathyroidism lesions.