国际放射医学核医学杂志
國際放射醫學覈醫學雜誌
국제방사의학핵의학잡지
INTERNATIONAL JOURNAL OF RADIATION MEDICINE AND NUCLEAR MEDICINE
2010年
2期
84-87
,共4页
苏莉%黄诚刚%牛文强%邬礼文
囌莉%黃誠剛%牛文彊%鄔禮文
소리%황성강%우문강%오례문
甲状腺功能亢进,原发性%甲状旁腺功能亢进症,继发性%甲状旁腺素%体层摄影术,发射型计算机,单光子%99m锝甲氧基异丁基异腈%99m锝美罗酸盐
甲狀腺功能亢進,原髮性%甲狀徬腺功能亢進癥,繼髮性%甲狀徬腺素%體層攝影術,髮射型計算機,單光子%99m锝甲氧基異丁基異腈%99m锝美囉痠鹽
갑상선공능항진,원발성%갑상방선공능항진증,계발성%갑상방선소%체층섭영술,발사형계산궤,단광자%99m득갑양기이정기이정%99m득미라산염
Hyperparathyroidism,primary%Hyperparathyroidism,secondary%Parathyroid hormone%Tomography,emission-computed,single-photon%Technetium 99Tcm sestamibi%Technetium 99Tcm medronate
目的 探讨血清甲状旁腺激素(PTH)升高的甲状旁腺相关疾病的核医学诊断方法和体会.方法 对25例甲状旁腺相关疾病患者进行99Tcm-MIBI SPECT双时相法甲状旁腺显像及99Tcm-亚甲基二膦酸盐(99Tcm-MDP)全身骨静态显像法显像,同时测定血清PTH和血清钙、磷及碱性磷酸酶含量.结果 ①原发性甲状旁腺功能亢进(PHPT)和继发性甲状旁腺功能亢进(SHPT)者血清PTH水平呈不同程度升高,其中PHPT较明显.②PHPT和SHPT患者手术前后PTH水平的变化明显,t分别为6.24和6.85,P均＜0.01;③PHPT患者全身骨显像常呈典型的代谢性骨病骨显像特点,甲状旁腺99Tcm-MIBI双时相显影阳性率为90%以上;④SHPT患者全身骨显像表现多样,常因血本底偏高,骨/组织放射性计数值降低,使骨显像的清晰度受到影响,但通常以骨摄取显像剂增多为主.99Tcm-MIBI双时相甲状旁腺显像多有不同程度的甲状旁腺增生,达56%以上.结论 甲状旁腺、全身骨SPECT检查结合血清PTH水平测定的方法对甲状旁腺相关疾病的诊断及指导治疗具有很高的临床应用价值.
目的 探討血清甲狀徬腺激素(PTH)升高的甲狀徬腺相關疾病的覈醫學診斷方法和體會.方法 對25例甲狀徬腺相關疾病患者進行99Tcm-MIBI SPECT雙時相法甲狀徬腺顯像及99Tcm-亞甲基二膦痠鹽(99Tcm-MDP)全身骨靜態顯像法顯像,同時測定血清PTH和血清鈣、燐及堿性燐痠酶含量.結果 ①原髮性甲狀徬腺功能亢進(PHPT)和繼髮性甲狀徬腺功能亢進(SHPT)者血清PTH水平呈不同程度升高,其中PHPT較明顯.②PHPT和SHPT患者手術前後PTH水平的變化明顯,t分彆為6.24和6.85,P均＜0.01;③PHPT患者全身骨顯像常呈典型的代謝性骨病骨顯像特點,甲狀徬腺99Tcm-MIBI雙時相顯影暘性率為90%以上;④SHPT患者全身骨顯像錶現多樣,常因血本底偏高,骨/組織放射性計數值降低,使骨顯像的清晰度受到影響,但通常以骨攝取顯像劑增多為主.99Tcm-MIBI雙時相甲狀徬腺顯像多有不同程度的甲狀徬腺增生,達56%以上.結論 甲狀徬腺、全身骨SPECT檢查結閤血清PTH水平測定的方法對甲狀徬腺相關疾病的診斷及指導治療具有很高的臨床應用價值.
목적 탐토혈청갑상방선격소(PTH)승고적갑상방선상관질병적핵의학진단방법화체회.방법 대25례갑상방선상관질병환자진행99Tcm-MIBI SPECT쌍시상법갑상방선현상급99Tcm-아갑기이련산염(99Tcm-MDP)전신골정태현상법현상,동시측정혈청PTH화혈청개、린급감성린산매함량.결과 ①원발성갑상방선공능항진(PHPT)화계발성갑상방선공능항진(SHPT)자혈청PTH수평정불동정도승고,기중PHPT교명현.②PHPT화SHPT환자수술전후PTH수평적변화명현,t분별위6.24화6.85,P균＜0.01;③PHPT환자전신골현상상정전형적대사성골병골현상특점,갑상방선99Tcm-MIBI쌍시상현영양성솔위90%이상;④SHPT환자전신골현상표현다양,상인혈본저편고,골/조직방사성계수치강저,사골현상적청석도수도영향,단통상이골섭취현상제증다위주.99Tcm-MIBI쌍시상갑상방선현상다유불동정도적갑상방선증생,체56%이상.결론 갑상방선、전신골SPECT검사결합혈청PTH수평측정적방법대갑상방선상관질병적진단급지도치료구유흔고적림상응용개치.
Objective To explore nuclear medicine diagnostic method for parathyroid disease accompanied elevated serum parathyroid hormone ( PTH ) level. Methods The images of 25 patients with parathyroid disease were obtained by SPECT 99Tcm-MIBI double-phase parathyroid imaging and 99Tcm-methylene diphosphonate(99Tcm-MDP) whole-body static bone imaging. All subject were measured serum PTH,calcium, phosphorus and alkaline phosphatase. Results ①Serum PTH level increased to varying degrees in patients with primary hyperparathyroidism(PHPT), secondary hyperparathyroidism(SHPT). ②PHPT and SHPT showed significant change before and after surgery (t=6.24 and t=6.85, P＜0.01). ③The whole-body static bone images of PHPT patients were characterized by metabolic bone disease images. The ositive rates of 99Tcm-MIBI were above 90％. ④Whole-body bone imaging results of SHPT patients showed complex and diverse caused by high background, increased uptakes mainly. 99Tcm-MIBI dual-phase parathyroid imaging showed hyperparathyroidism in varying egree, up to 56％ or more. Conclusion Determination of serum PTH combined SPECT for parathyroid and whole-body bone imaging howed high clinical value in diagnosis and treatment of parathyroid disease.
