中国实用医刊
中國實用醫刊
중국실용의간
CENTRAL PLAINS MEDICAL JOURNAL
2014年
8期
7-9
,共3页
韩军%韩星敏%程兵%谢新立
韓軍%韓星敏%程兵%謝新立
한군%한성민%정병%사신립
原发性甲状旁腺功能亢进症%99m锝-甲氧基异丁基异腈%单光子发射型计算机断层显像/计算机断层扫描%超声%定位诊断
原髮性甲狀徬腺功能亢進癥%99m锝-甲氧基異丁基異腈%單光子髮射型計算機斷層顯像/計算機斷層掃描%超聲%定位診斷
원발성갑상방선공능항진증%99m득-갑양기이정기이정%단광자발사형계산궤단층현상/계산궤단층소묘%초성%정위진단
Primary hyperparathyroidism%99mTc-sestamibi%Single photon emission computed tomography/computerized tomography%Ultrasound%Localization diagnosis
目的 探讨99m锝-甲氧基异丁基异腈(99mTc-MIBI)单光子发射型计算机断层显像/计算机断层扫描(SPECT/CT)双时相显像对原发性甲状旁腺功能亢进症(pHPT)的术前定位诊断价值,并与超声检查比较.方法 58例经病理证实的pHPT患者术前均行99mTc-MIBI SPECT/CT双时相甲状旁腺显像及颈部超声检查,将检查结果与手术及病理结果比较,同时伴随的甲状腺病理结果也被记录.采用配对x2检验,比较两种检查方法对甲状旁腺病灶的检出率.结果 术后病理证实58例pHPT患者共有78枚甲状旁腺病灶,其中腺瘤47枚(包括2枚异位腺瘤),增生28枚,腺癌3枚.99mTc-MIBI SPECT/CT对pHPT病灶的总的检出率为79.5％,明显高于超声的检出率(62.8％),x2 =7.579,P＜0.05.伴有甲状腺疾病的17例患者中,99mTc-MIBI SPECT/CT和超声对甲状旁腺病灶的检出率分别为71.4％和46.4％,二者比较差异有统计学意义(x2=4.000,P＜0.05).而对于不伴有甲状腺疾病的41例pHPT患者MIBI和超声对甲状旁腺病灶的检出率分别为92.0％,78.0％,二者比较差异无统计学意义(x2=3.273,P＞0.05).结论 99mTc-MIBI SPECT/CT是定位pHPT病灶的有效方法,对于伴有甲状腺疾病的pHPT及异位的甲状旁腺病灶,其定位价值高于超声.
目的 探討99m锝-甲氧基異丁基異腈(99mTc-MIBI)單光子髮射型計算機斷層顯像/計算機斷層掃描(SPECT/CT)雙時相顯像對原髮性甲狀徬腺功能亢進癥(pHPT)的術前定位診斷價值,併與超聲檢查比較.方法 58例經病理證實的pHPT患者術前均行99mTc-MIBI SPECT/CT雙時相甲狀徬腺顯像及頸部超聲檢查,將檢查結果與手術及病理結果比較,同時伴隨的甲狀腺病理結果也被記錄.採用配對x2檢驗,比較兩種檢查方法對甲狀徬腺病竈的檢齣率.結果 術後病理證實58例pHPT患者共有78枚甲狀徬腺病竈,其中腺瘤47枚(包括2枚異位腺瘤),增生28枚,腺癌3枚.99mTc-MIBI SPECT/CT對pHPT病竈的總的檢齣率為79.5％,明顯高于超聲的檢齣率(62.8％),x2 =7.579,P＜0.05.伴有甲狀腺疾病的17例患者中,99mTc-MIBI SPECT/CT和超聲對甲狀徬腺病竈的檢齣率分彆為71.4％和46.4％,二者比較差異有統計學意義(x2=4.000,P＜0.05).而對于不伴有甲狀腺疾病的41例pHPT患者MIBI和超聲對甲狀徬腺病竈的檢齣率分彆為92.0％,78.0％,二者比較差異無統計學意義(x2=3.273,P＞0.05).結論 99mTc-MIBI SPECT/CT是定位pHPT病竈的有效方法,對于伴有甲狀腺疾病的pHPT及異位的甲狀徬腺病竈,其定位價值高于超聲.
목적 탐토99m득-갑양기이정기이정(99mTc-MIBI)단광자발사형계산궤단층현상/계산궤단층소묘(SPECT/CT)쌍시상현상대원발성갑상방선공능항진증(pHPT)적술전정위진단개치,병여초성검사비교.방법 58례경병리증실적pHPT환자술전균행99mTc-MIBI SPECT/CT쌍시상갑상방선현상급경부초성검사,장검사결과여수술급병리결과비교,동시반수적갑상선병리결과야피기록.채용배대x2검험,비교량충검사방법대갑상방선병조적검출솔.결과 술후병리증실58례pHPT환자공유78매갑상방선병조,기중선류47매(포괄2매이위선류),증생28매,선암3매.99mTc-MIBI SPECT/CT대pHPT병조적총적검출솔위79.5％,명현고우초성적검출솔(62.8％),x2 =7.579,P＜0.05.반유갑상선질병적17례환자중,99mTc-MIBI SPECT/CT화초성대갑상방선병조적검출솔분별위71.4％화46.4％,이자비교차이유통계학의의(x2=4.000,P＜0.05).이대우불반유갑상선질병적41례pHPT환자MIBI화초성대갑상방선병조적검출솔분별위92.0％,78.0％,이자비교차이무통계학의의(x2=3.273,P＞0.05).결론 99mTc-MIBI SPECT/CT시정위pHPT병조적유효방법,대우반유갑상선질병적pHPT급이위적갑상방선병조,기정위개치고우초성.
Objective To evaluate the preoperative localization value of 99mTc-sestamibi (99mTc-MIBI) single photon emission computed tomography/computerized tomography (SPECT/CT) dual-phase imaging on patients with primary hyperparathyroidism (pHPT),and was compare with neck ultrasound (US).Methods 99mTc-MIBI SPECT/CT dual-phase imaging and neck ultrasound were performed preoperatively in 58 patients with pHPT confirmed by pathology.The imaging findings were compared with the operative and pathological results.Concomitant thyroid pathology was also recorded.The paired chisquare test was used to compare the detection rate between the two imaging techniques.Results Fiftyeight patients were diagnosed pathologically with a total of 78 parathyroid lesions,there were 47 adenomas (including two ectopic adenomas),28 hyperplasia lesions and 3 parathyroid carcinomas.99mTc-MIBI SPECT/CT identified 79.5％ of the pHPT lesions,with significantly higher detection rate than that of US (62.8％),x2 =7.579,P ＜ 0.05.MIBI and US identified the parathyroid pathology in 71.4％ and 46.4％ in the concomitant thyroid disease group of 17 patients,respectively,and in 92.0％ and 78.0％ in the non-concomitant thyroid disease group of 41 patients,respectively.Significant differences were found in the concomitant thyroid disease group (x2 =4.000,P ＜ 0.05) and were not found in the non-concomitant thyroid disease group(x2 =3.273,P ＞0.05).Conclusions 99mTc-MIBI SPECT/CT is more effective than US in locating pHPT lesions that are concomitant thyroid disease and ectopic.
