99mTc—MIBISPECT结合定位CT显像诊断功能-南京医科大学学报.doc

SPECT／CT对继发性甲状旁腺功能亢进症甲状旁腺腺体定位诊断的应用价值分析 袁孝军Δ , 李永军* , 徐兆强* （Δ江苏省省级机关医院医学影像科，江苏 南京 10024; * 南京医科大学第一附属医院核医学科，江苏 南京 210029） 【摘要】 目的：分析SPECT／CT同机断层融合显像对继发性甲状旁腺功能亢进症（SHPT）甲状旁腺腺体定位诊断的应用价值。方法：35例SHPT患者常规行99 mTc- MIBI（99 mTc -甲氧基异丁基异腈）-双时相平面显像（以下简称MIBI平面），共出现46处甲状腺床外的异常放射性摄取灶，对颈部及床外异常摄取灶行SPECT／CT同机断层融合显像，根据手术病理结果比较MIBI平面、SPECT／CT对甲状腺床位置甲状旁腺（以下简称常位甲状旁腺）与异位甲状旁腺在敏感性及假阳性方面的差别。结果： MIBI平面及SPECT／CT对常位甲状旁腺敏感性相似（63.9%，67.0%，P 0.05），SPECT／CT的假阳性百分比低于MIBI平面 （3.0%，18.4%，P 0.05） ，MIBI平面及SPECT／CT对异位甲状旁腺敏感性敏感性均为92.5%，SPECT／CT对异位甲状旁腺的假阳性百分比低于MIBI平面（2.6%，19.6%，P 0.05），SPECT／CT对异位甲状旁腺敏感性明显高于常位甲状旁腺（92.5%，67.0%，P 0.05）。结论：SPECT／CT检查不能明显提高对甲状旁腺腺体定位诊断的敏感性，但明显减少假阳性，尤其对异位甲状旁腺有更高的临床应用价值。 【关键词】继发性甲状旁腺功能亢进症；放射性核素显像；体层摄影术；发射型计算机；融合显像 The value of SPECT／CT in diagnosing parathyroid in patients with Secondary Hyperparathyroidism YUAN Xiao-jun , LI yong-jun1 , XU Zhao-qiang1 (Department of Medicial Image，Jiangsu Offical Hospital, Nanjing 210029 ; 1 Department of Nuclear Medicine ,the First Affiliated Hospital of NJMU , Nanjing 210029 China) 【Abstract】 Objective： To analysis the value of single-photon emission tomography／computed tomography(SPECT／CT ) in diagnosing parathyroid in patients with Hyperparathyroidism .Methods：35 patients with secondary hyperparathyroidism （SHPT）were performed 99 mTc – MIBI（99 mTc -methoxyisobutylisonitrile） Dual-phase Planar Scintigraphy （ below named MIBI Planar ）,and 46 focis outside of thyroid-bed were observed . SPECT／CT imaging including neck and additional radical uptake Was added in them. The difference in sensitivity and false positive percent(below named FPP) between MIBI Planar and SPECT／CT in finding the normalsite parathyroid and ectopic parathyroid were compared according the pathology.Results： The sensitivity of MIBI Planar in finding the normalsite parathyroid was similar to SPECT/CT（63.9%，67.0%，P 0.05）,the FPP was significantly lower than SPECT/CT（5.8%，28.6%，P 0.05）. The sensitivity of MIBI Planar in finding the ectop