CAJ | 학술논문

目的评价原发性甲状旁腺功能亢进症(简称甲旁亢)诊断中99Tcm-MIBI显像与血清全段PTH测定结果间的关系.方法对70例临床疑诊甲旁亢患者行血清全段PTH测定和99Tcm-MIBI显像.血清PTH＞88 ng/L为诊断甲旁亢依据;99Tcm-MIBI显像以早期相发现且延迟相显示相对清晰的异常放射性浓聚灶为病变腺体的检出依据.对照最终临床诊断结果,评价99Tcm-MIBI显像对病变甲状旁腺的检出效能及与血清PTH检测结果的关系;并以Pearson直线相关分析法分析血清PTH水平与病变腺体体积之间的相关性.结果 70例患者中最终证实为甲旁亢者38例.99Tcm-MIBI显像对70例患者的诊断准确性为90.0%(63/70);在PTH正常组为80.0%(12/15),在PTH升高组为92.7%(51/55);假阳性均见于PTH正常者.若99Tcm-MIBI显像诊断甲状旁腺病变以PTH升高为前提,则总体诊断准确性为94.3%(66/70);Pearson直线相关分析显示,原发性甲旁亢患者血清PTH水平与病变腺体体积之间呈正相关(r=0.782,P＜0.001).结论甲状旁腺病变腺体行99Tcm-MIBI显像时应先测定血清PTH,以提高99Tcm-MIBI显像的诊断准确性.
목적 평개원발성갑상방선공능항진증(간칭갑방항)진단중99Tcm-MIBI현상여혈청전단PTH측정결과간적관계.방법 대70례림상의진갑방항환자행혈청전단PTH측정화99Tcm-MIBI현상.혈청PTH＞88 ng/L위진단갑방항의거;99Tcm-MIBI현상이조기상발현차연지상현시상대청석적이상방사성농취조위병변선체적검출의거.대조최종림상진단결과,평개99Tcm-MIBI현상대병변갑상방선적검출효능급여혈청PTH검측결과적관계;병이Pearson직선상관분석법분석혈청PTH수평여병변선체체적지간적상관성.결과 70례환자중최종증실위갑방항자38례.99Tcm-MIBI현상대70례환자적진단준학성위90.0%(63/70);재PTH정상조위80.0%(12/15),재PTH승고조위92.7%(51/55);가양성균견우PTH정상자.약99Tcm-MIBI현상진단갑상방선병변이PTH승고위전제,칙총체진단준학성위94.3%(66/70);Pearson직선상관분석현시,원발성갑방항환자혈청PTH수평여병변선체체적지간정정상관(r=0.782,P＜0.001).결론 갑상방선병변선체행99Tcm-MIBI현상시응선측정혈청PTH,이제고99Tcm-MIBI현상적진단준학성.
Objective To evaluate 99Tcm-MIBI imaging in patients with hyperparathyroidism and its correlation with serum intact PTH level. Methods Seventy patients with suspicious hyperparathyroidism underwent 99Tcm-MIBI imaging and serum intact PTH measurement. Abnormal increased uptake lesion appeared at early phase and even more clearly at delayed phase was considered as the positive by 99Tcm-MIBI imaging. A cut-off value of PTH ＞ 88 ng/L was taken as the criteria for hyperparathyroidism diagnosis. The diagnostic efficacy of 99Tcm-MIBI imaging combined with serum PTH measurement was assessed according to post-surgical histopathology or clinical follow-up. For those operated patients, Pearson correlation coefficient between serum PTH and the gland volume was calculated. Results Hyperparathyroidism was confirmed in 38 patients by histopathology (n = 36) or follow-up (n = 2). The overall diagnostic accuracy of 99Tcm-MIBI imaging was 90.0% (63/70), in which the accuracy was 80.0% (12/15) for patients with normal serum PTH and 92.7% (51/55) for those with elevated serum PTH. False positive 99Tcm-MIBI imaging were found in 3 patients with normal serum PTH. The diagnostic accuracy of abnormally high serum PTH combined with 99Tcm-MIBI imaging was 94.3% (66/70). There was a positive correlation between serum PTH level and the volume of pathologic parathyroid glands (r = 0.782, P ＜ 0.001 ). Conclusions Serum PTH measurement may help to improve the diagnostic accuracy of 99Tcm-MIBI imaging in patients with hyperparathyroidism.