中华核医学杂志
中華覈醫學雜誌
중화핵의학잡지
CHINESE JOURNAL OF NUCLEAR MEDICINE
2010年
1期
42-45
,共4页
甲状旁腺功能亢进症%迷芽瘤%体层摄影术,发射型计算机%单光子%体层摄影术,X线计算机%MIBI
甲狀徬腺功能亢進癥%迷芽瘤%體層攝影術,髮射型計算機%單光子%體層攝影術,X線計算機%MIBI
갑상방선공능항진증%미아류%체층섭영술,발사형계산궤%단광자%체층섭영술,X선계산궤%MIBI
Hyperparathyroidism%Choristoma%Tomography,emission-computed,single-photon%Tomography,X-ray computed%MIBI
目的 评价~(99)Tc~m-甲氧基异丁基异腈(MIBI)SPECT结合定位CT显像对功能亢进异位甲状旁腺的定位诊断价值.方法 回顾性分析28例功能亢进异位甲状旁腺患者的手术、病理及影像资料.28例均行常规CT检查,其中25例先行双时相~(99)Tc~m-MIBI显像,对甲状腺外存在异常放射性浓聚灶患者,随即进行SPECT结合定位CT采集,经计算机处理得到二者融合图像,对放射性浓聚灶进行精确定位.以手术及病理检查结果 为检查"金标准",所有患者均按4个甲状旁腺计算,经手术及病理检查证实的为阳性,其余判为阴性.CT检查与核医学显像结果 的比较采用四格表X2检验.结果 手术中28例患者共摘除28个异位病灶,均为单发.病理检查结果 均为腺瘤.28例患者常规CT检查共发现22个阳性病灶,其中真阳性17个,假阳性5个,另假阴性11个,真阴性79个;25例~(99)Tc~m-MIBI SPECT结合定位CT显像发现阳性病灶23个,无假阳性,另假阴性2个,真阴性75个.常规CT检查与核医学显像对检出病理性甲状旁腺的灵敏度分别为61%(17/28)、92%(23/25),特异性为94%(79/84)、100%(75/75),准确性为86%(96/112)、98%(98/100),阳性预测值为77%(17/22)、100%(23/23),阴性预测值为88%(79/90)、97%(75/77);两者间比较差异有统计学意义,灵敏度:X~2=6.98,P＜0.01,特异性:X~2=4.61,P＜0.05,准确性:X~2=10.30,P＜0.01,阳性预测值:X~2=5.88,P＜0.05,阴性预测值:X~2=5.36,P＜0.05.结论 ~(99)Tc~m-MIBI SPECT结合定位CT显像对功能亢进异位甲状旁腺的定位诊断优于常规CT,但存在一定的假阴性.
目的 評價~(99)Tc~m-甲氧基異丁基異腈(MIBI)SPECT結閤定位CT顯像對功能亢進異位甲狀徬腺的定位診斷價值.方法 迴顧性分析28例功能亢進異位甲狀徬腺患者的手術、病理及影像資料.28例均行常規CT檢查,其中25例先行雙時相~(99)Tc~m-MIBI顯像,對甲狀腺外存在異常放射性濃聚竈患者,隨即進行SPECT結閤定位CT採集,經計算機處理得到二者融閤圖像,對放射性濃聚竈進行精確定位.以手術及病理檢查結果 為檢查"金標準",所有患者均按4箇甲狀徬腺計算,經手術及病理檢查證實的為暘性,其餘判為陰性.CT檢查與覈醫學顯像結果 的比較採用四格錶X2檢驗.結果 手術中28例患者共摘除28箇異位病竈,均為單髮.病理檢查結果 均為腺瘤.28例患者常規CT檢查共髮現22箇暘性病竈,其中真暘性17箇,假暘性5箇,另假陰性11箇,真陰性79箇;25例~(99)Tc~m-MIBI SPECT結閤定位CT顯像髮現暘性病竈23箇,無假暘性,另假陰性2箇,真陰性75箇.常規CT檢查與覈醫學顯像對檢齣病理性甲狀徬腺的靈敏度分彆為61%(17/28)、92%(23/25),特異性為94%(79/84)、100%(75/75),準確性為86%(96/112)、98%(98/100),暘性預測值為77%(17/22)、100%(23/23),陰性預測值為88%(79/90)、97%(75/77);兩者間比較差異有統計學意義,靈敏度:X~2=6.98,P＜0.01,特異性:X~2=4.61,P＜0.05,準確性:X~2=10.30,P＜0.01,暘性預測值:X~2=5.88,P＜0.05,陰性預測值:X~2=5.36,P＜0.05.結論 ~(99)Tc~m-MIBI SPECT結閤定位CT顯像對功能亢進異位甲狀徬腺的定位診斷優于常規CT,但存在一定的假陰性.
목적 평개~(99)Tc~m-갑양기이정기이정(MIBI)SPECT결합정위CT현상대공능항진이위갑상방선적정위진단개치.방법 회고성분석28례공능항진이위갑상방선환자적수술、병리급영상자료.28례균행상규CT검사,기중25례선행쌍시상~(99)Tc~m-MIBI현상,대갑상선외존재이상방사성농취조환자,수즉진행SPECT결합정위CT채집,경계산궤처리득도이자융합도상,대방사성농취조진행정학정위.이수술급병리검사결과 위검사"금표준",소유환자균안4개갑상방선계산,경수술급병리검사증실적위양성,기여판위음성.CT검사여핵의학현상결과 적비교채용사격표X2검험.결과 수술중28례환자공적제28개이위병조,균위단발.병리검사결과 균위선류.28례환자상규CT검사공발현22개양성병조,기중진양성17개,가양성5개,령가음성11개,진음성79개;25례~(99)Tc~m-MIBI SPECT결합정위CT현상발현양성병조23개,무가양성,령가음성2개,진음성75개.상규CT검사여핵의학현상대검출병이성갑상방선적령민도분별위61%(17/28)、92%(23/25),특이성위94%(79/84)、100%(75/75),준학성위86%(96/112)、98%(98/100),양성예측치위77%(17/22)、100%(23/23),음성예측치위88%(79/90)、97%(75/77);량자간비교차이유통계학의의,령민도:X~2=6.98,P＜0.01,특이성:X~2=4.61,P＜0.05,준학성:X~2=10.30,P＜0.01,양성예측치:X~2=5.88,P＜0.05,음성예측치:X~2=5.36,P＜0.05.결론 ~(99)Tc~m-MIBI SPECT결합정위CT현상대공능항진이위갑상방선적정위진단우우상규CT,단존재일정적가음성.
Objective To evaluate the diagnostic value of ~(99)Tc~m-methoxyisobutylisonitrile (MIBI) SPECT scintigraphy combined Iocalizable CT in the localization of ectopic parathyroid glands in hyperparathyroidism.Methods Retrospective data of surgery,pathology and imaging were collected from 28 patients with hyperfunctioning ectopic parathyroid glands.All cases underwent CT studies.Twenty-five patients had ~(99)Tc~m-MIBI planar imaging first:SPECT scintigraphy combined localizable CT was performed for the patients with abnormal radionuclide foci immediately.The fusion images obtained after reconstruction showed the exact location of the ectopic foci.Operative histopathologic results were regarded as "gold standards".Presuming 4 parathyroid glands as normal findings,findings confirmed by operation and pathology were regarded as positive,otherwise negative.The results of CT and radionuclide imaging were compared by X~2-test of four-foId table.Results Twenty-eight ectopic parathyroid glands were found in 28 patients,all pathologically confirmed as adenomss.CT found 22 foci,of which 17 were true positive,5 false positive,11 false negative,and 79 true negative.~(99)Tc~m-MIBI SPECT scintigraphy combined localizable CT found 23 foci,no false positive,2 false negative,and 75 true negative.The results showed that the sensitivities were 61% (17/28),92%(23/25),specificities 94%(79/84),100%(75/75),accuracies 86%(96/112),98% (98/100),positive predictive values 77%(17/22),100%(23/23),and negative predictive values 88% (79190),97%(75/77),respectively,for CT and radionuclide imaging.~(99)Tc~m-MIBI SPECT scintigraphy combined localizable CT was therefore significantly higher than CT in sensitivity(X~2=6.98,P＜0.01),specificity (X~2=4.61,P＜0.05),accuracy (X~2=10.30,P＜0.01),positive predictive value(X~2=5.88,P＜0.05) and negative predictive value (X~2=5.36,P＜0.05).Conclusion ~(99)Tc~m-MIBI SPECT scintigraphy combined localizable CT is superior to CT alone in the localization of ectopic parathyroid glands in hyperparathyroidism,but false negative can be found in some patients.
