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不同类型甲状旁腺功能亢进症术前行 99Tc m-MIBI SPECT/CT断层显像最佳时机探索
谢亦驰
孔维唯
尤嘉熙
王宁
朱怡蓉
洪智慧
石怡珍
作者及单位信息
·
DOI： 10.3760/cma.j.cn321828-20240527-00177
Exploring the optimal timing of preoperative 99Tc m-MIBI SPECT/CT imaging in different types of hyperparathyroidism
Xie Yichi
Kong Weiwei
You Jiaxi
Wang Ning
Zhu Yirong
Hong Zhihui
Shi Yizhen
Authors Info & Affiliations
Xie Yichi
Department of Nuclear Medicine, the Second Affiliated Hospital of Soochow University, Suzhou 215004, China
Kong Weiwei
Department of Nuclear Medicine, the Second Affiliated Hospital of Soochow University, Suzhou 215004, China
You Jiaxi
Department of Nuclear Medicine, the Second Affiliated Hospital of Soochow University, Suzhou 215004, China
Wang Ning
Department of Nuclear Medicine, the Second Affiliated Hospital of Soochow University, Suzhou 215004, China
Zhu Yirong
Department of Nuclear Medicine, the Second Affiliated Hospital of Soochow University, Suzhou 215004, China
Hong Zhihui
Department of Nuclear Medicine, the Second Affiliated Hospital of Soochow University, Suzhou 215004, China
Shi Yizhen
Department of Nuclear Medicine, the Second Affiliated Hospital of Soochow University, Suzhou 215004, China
·
DOI： 10.3760/cma.j.cn321828-20240527-00177
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摘要

目的分别比较 99Tc m-甲氧基异丁基异腈(MIBI)双时相平面显像早期相后或延迟相后加做SPECT/CT断层显像在不同类型甲状旁腺功能亢进症中的诊断效能差异，寻求术前最佳显像时机。

方法回顾性分析2016年1月至2024年6月苏州大学附属第二医院临床诊断为原发性或继发性甲状旁腺功能亢进症并有病理结果的339例患者[男148例、女191例，年龄(52±13)岁]。将患者分成原发性早期断层显像组( n＝63)与延迟断层显像组( n＝47)、继发性早期断层显像组( n＝89)与延迟断层显像组( n＝140)。采用 χ 2检验比较早期与延迟断层显像的诊断效能差异。

结果原发性延迟与早期断层显像间的准确性[98.40%(185/188)与94.84%(239/252)]的差异具有统计学意义( χ 2＝3.90， P＝0.048)。继发性延迟与早期断层显像间的灵敏度[77.29%(405/524)与85.40%(275/322)]、准确性[75.89%(425/560)与83.99%(299/356)]、阴性预测值[14.39%(20/139)与33.80%(24/71)]的差异具有统计学意义( χ 2值：8.33、8.61、10.70，均 P<0.01)。

结论原发性和继发性甲状旁腺功能亢进症术前双时相平面显像加做断层显像的最佳时机分别为延迟相后和早期相后。

甲状旁腺功能亢进症;99m锝甲氧基异丁基异腈;体层摄影术，发射型计算机，单光子;体层摄影术，X线计算机
ABSTRACT

ObjectiveTo compare the diagnostic efficacy of the added 99Tc m-methoxyisobutylisonitrile (MIBI) SPECT/CT imaging (tomography imaging) after early or delayed planar imaging in different types of hyperparathyroidism, and to seek for the optimal timing of preoperative imaging.

MethodsA total of 339 patients (148 males, 191 females, age (52±13) years) with primary or secondary hyperparathyroidism and pathological results from January 2016 to June 2024 in the Second Affiliated Hospital of Soochow University were retrospectively analyzed. The patients were divided into primary early tomography imaging group ( n=63) and delayed tomography imaging group ( n=47), secondary early tomography imaging group ( n=89) and delayed tomography imaging group ( n=140). χ 2 test was used to compare the diagnostic efficacies of early and delayed tomography imaging.

ResultsThe difference of accuracy between primary delayed (98.40%(185/188)) and early tomography imaging (94.84%(239/252)) was statistically significant ( χ 2=3.90, P=0.048). There were significant differences in sensitivity (77.29%(405/524) and 85.40%(275/322)), accuracy (75.89%(425/560) and 83.99%(299/356)) and negative predictive value (14.39%(20/139) and 33.80%(24/71)) between secondary delayed and early tomography imaging ( χ 2 values: 8.33, 8.61, 10.70, all P<0.01).

ConclusionThe optimal timing of preoperative 99Tc m-MIBI SPECT/CT imaging for primary and secondary hyperparathyroidism is after delayed planar imaging and after early planar imaging respectively.

Hyperparathyroidism;Technetium Tc 99m sestamibi;Tomography, emission-computed, single-photon;Tomography, X-ray computed
Shi Yizhen, Email: mocdef.3ab6188ihsrdzs
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引用本文

谢亦驰,孔维唯,尤嘉熙,等. 不同类型甲状旁腺功能亢进症术前行 99Tc m-MIBI SPECT/CT断层显像最佳时机探索 [J]. 中华核医学与分子影像杂志,2025,45(03)：159-163.

DOI:10.3760/cma.j.cn321828-20240527-00177

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甲状旁腺功能亢进症在临床上最常见的类型有原发性甲状旁腺功能亢进症和继发性甲状旁腺功能亢进症2类，可导致体内甲状旁腺激素水平增高、血钙水平失调，从而出现骨骼、泌尿、消化系统等的一系列临床症状，是第三大常见的内分泌紊乱疾病 [ 1 ]。手术切除是唯一根治的方法。多项研究表明，在常规 99Tc m-甲氧基异丁基异腈(methoxyisobutylisonitrile, MIBI)双时相平面显像的基础上增加SPECT/CT断层显像，能明显提高诊断的灵敏度与准确性，更好地辅助手术治疗，但选择做断层显像的时机各项研究又不尽相同，且未对2类不同病因的甲状旁腺功能亢进症进行深入的断层显像时机比较 [ 2 , 3 , 4 , 5 , 6 ]。本研究拟回顾性分析多年来本科室进行的甲状旁腺显像资料，探索原发性与继发性甲状旁腺功能亢进症患者不同断层显像时机的诊断效能差异，为术前检查寻求个性化断层显像方法。
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参考文献
[1]
Cetani F , Marcocci C , Torregrossa L ,et al. Atypical parathyroid adenomas: challenging lesions in the differential diagnosis of endocrine tumors[J]. Endocr Relat Cancer, 2019,26(7):R441-R464. DOI： 10.1530/ERC-19-0135 .
返回引文位置Google Scholar
百度学术
万方数据
[2]
陈则君，薛勤，付晶晶，等．基于SPECT/CT甲状旁腺显像同机CT评估慢性肾脏病继发性甲状旁腺功能亢进症主动脉弓钙化的初步应用[J]. 中华核医学与分子影像杂志， 2023,43(4):226-229. DOI： 10.3760/cma.j.cn321828-20211025-00369 .
返回引文位置Google Scholar
百度学术
万方数据
Chen ZJ , Xue Q , Fu JJ ,et al. Preliminary application of CT on accessing aortic arch calcification during parathyroid SPECT/CT in patients with renal secondary hyperparathyroidism[J]. Chin J Nucl Med Mol Imaging, 2023,43(4):226-229. DOI： 10.3760/cma.j.cn321828-20211025-00369 .
Goto CitationGoogle Scholar
Baidu Scholar
Wanfang Data
[3]
陈正国，刘启榆，吴春燕，等. SPECT/CT融合显像在继发性甲状旁腺功能亢进症中的临床价值[J]. 中国临床医学影像杂志， 2019,30(3):169-173. DOI： 10.12117/jccmi.2019.03.005 .
返回引文位置Google Scholar
百度学术
万方数据
Chen ZG , Liu QY , Wu CY ,et al. The diagnostic value of 99m Tc-sestamibi SPECT/CT in secondary hyperparathyroidism [J]. J Chin Clin Med Imaging, 2019,30(3):169-173. DOI： 10.12117/jccmi.2019.03.005 .
Goto CitationGoogle Scholar
Baidu Scholar
Wanfang Data
[4]
张莹莹，韩娜，武凤玉，等. 99 Tc m -MIBI SPECT/CT显像在原发性甲状旁腺功能亢进症术前诊断中的价值及影响因素 [J]. 中华核医学与分子影像杂志， 2021,41(6):345-349. DOI： 10.3760/cma.j.cn321828-20200408-00142 .
返回引文位置Google Scholar
百度学术
万方数据
Zhang YY , Han N , Wu FY ,et al. Value of 99 Tc m -MIBI SPECT/CT imaging in preoperative diagnosis of primary hyperparathyroidism and its influencing factors [J]. Chin J Nucl Med Mol Imaging, 2021,41(6):345-349. DOI： 10.3760/cma.j.cn321828-20200408-00142 .
Goto CitationGoogle Scholar
Baidu Scholar
Wanfang Data
[5]
魏瑶，张青，张庆，等. 99m Tc-MIBI SPECT/CT显像在甲状旁腺功能亢进症的术前诊断价值 [J]. 中国临床医学影像杂志， 2023,34(4):234-237. DOI： 10.12117/jccmi.2023.04.002 .
返回引文位置Google Scholar
百度学术
万方数据
Wei Y , Zhang Q , Zhang Q ,et al. Preoperative diagnostic value of 99m Tc-MIBI SPECT/CT imaging in hyperparathyroidism [J]. J Chin Clin Med Imaging, 2023,34(4):234-237. DOI： 10.12117/jccmi.2023.04.002 .
Goto CitationGoogle Scholar
Baidu Scholar
Wanfang Data
[6]
华茜，巢琳，倪建明，等. SPECT/CT对甲状旁腺功能亢进症病灶术前定位扫描方案的优化[J]. 中华核医学与分子影像杂志， 2018,38(5):320-324. DOI： 10.3760/cma.j.issn.2095-2848.2018.05.004 .
返回引文位置Google Scholar
百度学术
万方数据
Hua Q , Chao L , Ni JM ,et al. Optimization of SPECT/CT scan schemes in localizing preoperative parathyroid lesions[J]. Chin J Nucl Med Mol Imaging, 2018,38(5):320- 32 4 . DOI： 10.3760/cma.j.issn.2095-2848.2018.05.004 .
Goto CitationGoogle Scholar
Baidu Scholar
Wanfang Data
[7]
Rizk Y , Saad N , Arnaout W ,et al. Primary hyperparathyroidism in older adults: a narrative review of the most recent literature on epidemiology, diagnosis and management[J]. J Clin Med, 2023,12(19):6321. DOI： 10.3390/jcm12196321 .
返回引文位置Google Scholar
百度学术
万方数据
[8]
Hiramitsu T , Hasegawa Y , Futamura K ,et al. Treatment for secondary hyperparathyroidism focusing on parathyroidectomy[J]. Front Endocrinol (Lausanne), 2023,14:1169793. DOI： 10.3389/fendo.2023.1169793 .
返回引文位置Google Scholar
百度学术
万方数据
[9]
邓茂雪，舒巧巧，陈跃，等． 双时相 18 F-FCH PET/CT显像在尿毒症性甲状旁腺功能亢进症中的应用价值 [J]. 中华核医学与分子影像杂志， 2023,43(9):528-532. DOI： 10.3760/cma.j.cn321828-20220419-00116 .
返回引文位置Google Scholar
百度学术
万方数据
Deng MX , Shu QQ , Chen Y ,et al. Dual-phase 18 F-fluorocholine PET/CT imaging in uremic hyperparathyroidism [J]. Chin J Nucl Med Mol Imaging, 2023,43(9):528-532. DOI： 10.3760/cma.j.cn321828-20220419-00116 .
Goto CitationGoogle Scholar
Baidu Scholar
Wanfang Data
[10]
Petranović Ovčariček P , Giovanella L , Carrió Gasset I ,et al. The EANM practice guidelines for parathyroid imaging[J]. Eur J Nucl Med Mol Imaging, 2021,48(9):2801-2822. DOI： 10.1007/s00259-021-05334-y .
返回引文位置Google Scholar
百度学术
万方数据
[11]
Morris MA , Saboury B , Ahlman M ,et al. Parathyroid imaging: past, present, and future[J]. Front Endocrinol (Lausanne), 2022,12:760419. DOI： 10.3389/fendo.2021.760419 .
返回引文位置Google Scholar
百度学术
万方数据
[12]
Jorna FH , Hollema H , Hendrikse HN ,et al. P-gp and MRP1 expression in parathyroid tumors related to histology, weight and 99m Tc-sestamibi imaging results [J]. Exp Clin Endocrinol Diabetes, 2009,117(8):406-412. DOI： 10.1055/s-0028-1105925 .
返回引文位置Google Scholar
百度学术
万方数据
[13]
Palestro CJ , Tomas MB , Tronco GG . Radionuclide imaging of the parathyroid glands[J]. Semin Nucl Med, 2005,35(4):266-276. DOI： 10.1053/j.semnuclmed.2005.06.001 .
返回引文位置Google Scholar
百度学术
万方数据
[14]
Jiang SQ , Yang T , Zou Q ,et al. The role of 99m Tc-MIBI SPECT/CT in patients with secondary hyperparathyroidism: comparison with 99m Tc-MIBI planar scintigraphy and ultrasonography [J]. BMC Med Imaging, 2020,20(1):115. DOI： 10.1186/s12880-020-00517-9 .
返回引文位置Google Scholar
百度学术
万方数据
[15]
王海涛，赵红光，李群，等． 甲状旁腺 99m Tc-MIBI假阳性及假阴性原因分析及治疗对策 [J]. 中华普通外科杂志， 2020,35(7):579-580. DOI： 10.3760/cma.j.cn113855-20190522-00274 .
返回引文位置Google Scholar
百度学术
万方数据
Wang HT , Zhao HG , Li Q ,et al. Analysis of the causes of false-positive and false-negative parathyroid 99m Tc-MIBI and therapeutic countermeasures [J]. Chin J Gen Surg, 2020,35(7):579-580. DOI： 10.3760/cma.j.cn113855-20190522-00274 .
Goto CitationGoogle Scholar
Baidu Scholar
Wanfang Data
备注信息
A
石怡珍，Email: mocdef.3ab6188ihsrdzs
B

谢亦驰：研究实施、数据分析、论文撰写；孔维唯：统计学分析；尤嘉熙：数据采集；王宁、朱怡蓉：材料支持；洪智慧：技术支持；石怡珍：研究指导、论文修改

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