| 梅威琪,江茂情,马丽娟,褚玉,闯振蕾,冯金,王珏,楼岑.多模态影像学术前定位诊断原发性及继发于慢性肾病的甲状旁腺功能亢进症[J].中国医学影像技术,2023,39(10):1492~1496 |
| 多模态影像学术前定位诊断原发性及继发于慢性肾病的甲状旁腺功能亢进症 |
| Multimodal imaging for preoperative localization diagnosis of primary and secondary hyperparathyroidism due to chronic renal disease |
| 投稿时间：2023-06-05 修订日期：2023-08-07 |
| DOI：10.13929/j.issn.1003-3289.2023.10.011 |
| 中文关键词: 甲状旁腺功能亢进症 体层摄影术,发射型计算机,单光子 超声检查 |
| 英文关键词:hyperparathyroidism tomography, emission-computed, single-photon ultrasonography |
| 基金项目:宁波市省市共建重点学科-医学影像学(2022-S02)、宁波市影像医学临床医学研究中心(2021L003)、宁波市第二医院朱绣山人才激励基金-华美优青(2021hmyq07)。 |
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| 中文摘要: |
| 目的 对比99Tcm-MIBI双时相平面显像、SPECT/CT显像与超声术前定位诊断原发性甲状旁腺功能亢进症(PHPT)及继发于慢性肾病的甲状旁腺功能亢进症(SHPT)的价值。方法 纳入113例术前接受99Tcm-MIBI双时相平面显像、SPECT/CT显像和颈部超声检查的甲状旁腺功能亢进症(HPT)患者,包括95例PHPT及18例慢性肾病SHPT;以术后病理为标准,分析各影像学方法术前定位诊断的价值。结果 术后病理共于95例PHPT中诊断108处病灶,其中90处显像阳性、18处阴性;于18例慢性肾病后SHPT中诊断46处病灶,其中44处显像阳性、2处阴性。双时相平面显像、SPECT/CT显像和超声定位诊断PHPT的准确率分别为87.96%(95/108)、92.59%(100/108)和79.63%(86/108),定位诊断慢性肾病后SHPT准确率分别为58.70%(27/46)、86.96%(40/46)和71.74%(33/46),双时相平面显像对前者显著高于后者(P＜0.001)。双时相平面显像、SPECT/CT显像及超声诊断PHPT准确率差异均无统计学意义(P均＞0.05);对于慢性肾病后SHPT,SPECT/CT显像诊断准确性率显著高于双时相平面显像(P=0.004)而与超声差异无统计学意义(P=0.121),双时相平面显像与超声差异亦无统计学意义(P=0.274)。结论 99Tcm-MIBI双时相平面显像、SPECT/CT显像及超声术前定位诊断HPT准确率较高。双时相平面显像诊断PHPT效能优于慢性肾病后SPHT;推荐对慢性肾病后SHPT优先行SPECT/CT显像。 |
| 英文摘要: |
| Objective To compare the value of 99Tcm-MIBI dual phase planar imaging, SPECT/CT imaging and ultrasonography for preoperative localization diagnosis of primary hyperparathyroidism (PHPT) and secondary hyperparathyroidism (SHPT) due to chronic renal disease. Methods Data of 113 patients with hyperparathyroidism (HPT) who underwent 99Tcm-MIBI dual phase planar imaging, SPECT/CT imaging, and cervical ultrasonography before operation were analyzed, including 95 cases of PHPT and 18 cases of SHPT due to chronic renal disease. The value of each imaging method for preoperative localization diagnosis was evaluated according to postoperative pathology. Results Postoperative pathology diagnosed 108 lesions in 95 cases of PHPT, including 90 99Tcm-MIBI dual phase planar imaging or SPECT/CT imaging positive lesions and 18 negative lesions, also 46 lesions in 18 patients with SHPT due to chronic renal disease, including 44 imaging positive and 2 negative lesions. The accuracy of dual phase plane imaging, SPECT/CT imaging and ultrasonography for localization diagnosis of PHPT was 87.96% (95/108), 92.59% (100/108) and 79.63% (86/108), while for SHPT due to chronic renal disease was 58.70% (27/46), 86.96% (40/46), and 71.74% (33/46), respectively. The accuracy of dual phase plane imaging for preoperative localization diagnosis of PHPT was significantly higher than that of SHPT due to chronic renal disease (P＜0.001).No significant difference of diagnostic accuracy was found among dual phase plane imaging, SPECT/CT imaging and ultrasonography for preoperative localization diagnosis of PHPT (all P＞0.05).For SHPT due to chronic renal disease, the diagnostic accuracy of SPECT/CT imaging was significantly higher than that of dual phase plane imaging (P=0.004) but not significantly different compared with that of ultrasonography (P=0.121), and no significant difference was found between dual phase plane imaging and ultrasonography (P=0.274). Conclusion 99Tcm-MIBI dual phase plane imaging, SPECT/CT imaging and ultrasonography had high efficacy for preoperative localization diagnosis of HPT. Dual phase plane imaging had better efficacy for diagnosing PHPT than SPHT due to chronic renal disease. SPECT/CT imaging was recommended for patients with SHPT due to chronic renal disease. |
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