~(99m)Tc-MIBI联合~(99m)Tc-MDP显像诊断原发性甲状旁腺功能亢进症的价值
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摘要
目的探讨~(99m) Tc-MIBI联合~(99m) Tc-MDP显像诊断原发性甲状旁腺功能亢进症的价值。方法选取该院2015年1月—2017年1月收治的36例原发性甲状旁腺功能亢进症患者为研究对象,进行~(99m)Tc-MIBI双时相显像联合~(99m) Tc-MDP全身骨显像诊断,统计两组检测方法阳性率。结果有30例患者~(99m) Tc-MIBI双时相SPECT/CT显像甲状腺部位有异常影像,阳性率为83.33%(30/36),而同时期B超显示异常24例,阳性率为66.67%(24/36),~(99m) Tc-MIBI双时相SPECT/CT显像检查阳性率显著高于B超检查,差异有统计学意义(χ~2=7.401 5,P<0.05)。有20例患者~(99m) Tc-MDP全身骨显像有代谢性骨病表现,还有4例胃、心脏、肺显影,总阳性率为66.67%(24/36)。结论在甲状旁腺功能亢进的诊断中,~(99m) Tc-MIBI双时相SPECT/CT显像联合~(99m)Tc-MDP全身骨显像具有极大的临床价值,同时行~(99m) Tc-MDP骨扫描,可以帮助临床诊断原发性甲状旁腺功能亢进症。
Objective This paper tries to investigate the value of ~(99m)Tc-MIBI combined with~(99m)Tc-MDP imaging in the diagnosis of primary hyperparathyroidism. Methods 36 patients with primary hyperparathyroidism admitted to this hospital from January 2015 to January 2017 were selected for the study.~(99m)Tc-MIBI dual-phase imaging combined with ~(99m)Tc-MDP whole-body bone imaging was performed. Like diagnosis, statistics positive rate of the two groups of detection methods. Results 30 patients with ~(99m)Tc-MIBI dual-phase SPECT/CT imaging had abnormal images of the thyroid gland, the positive rate was 83.33%(30/36), while the B-mode ultrasound showed abnormalities at the same time in 24 cases, the positive rate was 66.67%(24/36),~(99m)Tc-MIBI dual-phase SPECT/CT imaging positive rate was significantly higher than B-ultrasound examination, the difference was statistically significant(χ~2=7.4015,P<0.05). 20 patients had ~(99m)Tc-MDP whole-body bone imaging with metabolic bone disease, and 4 cases had stomach, heart, and lung imaging.The total positive rate was 66.67%(24/36). Conclusion In the diagnosis of hyperparathyroidism,~(99m)Tc-MIBI dual-phase SPECT/CT imaging combined with~(99m)Tc-MDP whole-body bone imaging has great clinical value. At the same time,~(99m)Tc-MDP bone scan can help clinical diagnosis of primary hyperparathyroidism.
Objective This paper tries to investigate the value of ~(99m)Tc-MIBI combined with~(99m)Tc-MDP imaging in the diagnosis of primary hyperparathyroidism. Methods 36 patients with primary hyperparathyroidism admitted to this hospital from January 2015 to January 2017 were selected for the study.~(99m)Tc-MIBI dual-phase imaging combined with ~(99m)Tc-MDP whole-body bone imaging was performed. Like diagnosis, statistics positive rate of the two groups of detection methods. Results 30 patients with ~(99m)Tc-MIBI dual-phase SPECT/CT imaging had abnormal images of the thyroid gland, the positive rate was 83.33%(30/36), while the B-mode ultrasound showed abnormalities at the same time in 24 cases, the positive rate was 66.67%(24/36),~(99m)Tc-MIBI dual-phase SPECT/CT imaging positive rate was significantly higher than B-ultrasound examination, the difference was statistically significant(χ~2=7.4015,P<0.05). 20 patients had ~(99m)Tc-MDP whole-body bone imaging with metabolic bone disease, and 4 cases had stomach, heart, and lung imaging.The total positive rate was 66.67%(24/36). Conclusion In the diagnosis of hyperparathyroidism,~(99m)Tc-MIBI dual-phase SPECT/CT imaging combined with~(99m)Tc-MDP whole-body bone imaging has great clinical value. At the same time,~(99m)Tc-MDP bone scan can help clinical diagnosis of primary hyperparathyroidism.
引文
[1]亓玉彬,李栋,马焕芝.原发性甲状旁腺功能亢进症性病理性骨折的诊治启示[J].中华诊断学电子杂志,2017,5(4):277-280.
[2]黎俊,李莉,林华.~(99m)Tc-MIBI双时相显像与SPECT/CT融合显像对原发性甲状旁腺功能亢进症的诊断价值[J].医学影像学杂志,2017,27(6):1063-1067.
[3]李玮朋,王原,高茜,等.正常血钙型原发性甲状旁腺功能亢进症漏诊报告并文献复习[J].临床误诊误治,2017,30(2):45-47.
[4]王军,张宏,安宁,等.99m Tc-MIBI核素显像误诊为甲状旁腺腺瘤1例[J].中国医学文摘:耳鼻咽喉科学,2016,31(6):325-327.
[5]龚志琰.超声在甲状旁腺功能亢进症诊断及术前定位中应用[J].临床军医杂志,2016,44(10):1070-1073.
[6]刘晓杰,桂文来,蒋灵军.99m Tc-MIBI联合99m Tc-MDP显像诊断甲状旁腺功能亢进症的价值[J].世界最新医学信息文摘,2016,16(82):6-7.
[7]赵银龙,宋晓良,郝婷婷,等.99m Tc-MIBI双时相显像诊断原发性异位甲状旁腺亢进性腺瘤伴对侧甲状腺微小乳头状癌1例[J].中国实验诊断学,2016,20(9):1592-1594.
[8]于军霞,欧阳兆强,张霞,等.甲状旁腺腺瘤并原发性甲状旁腺功能亢进症临床特点及误诊原因分析[J].临床误诊误治,2015,28(11):21-25.
[9]许小飞,刘雅洁,张伟晓,等.288例肾功能不全继发甲状旁腺功能亢进核素扫描图像分析[J].南京医科大学学报:自然科学版,2015,35(9):1259-1261.
[10]赵敏,李新辉,黄金,等.SPECT/CT在甲状旁腺功能亢进中的诊断价值及其与多种影像学方法的比较[J].中南大学学报:医学版,2015,40(9):1016-1022.
[11]王晨,赵志刚,郑瑞芝.原发性甲状旁腺功能亢进39例诊断及治疗分析[J].中华实用诊断与治疗杂志,2015,29(5):458-459.
[12]李征.~(99m)Tc-MIBI SPECT-CT显像在纵隔内异位甲状旁腺诊治中的应用价值[J].检验医学与临床,2015,12(6):765-767.
[13]刘洋,朱莹莹,史莹,等.原发性甲状旁腺功能亢进症的诊治[J].中国实验诊断学,2015,19(2):230-232.
[14]张洋.探讨核医学诊断原发性甲状旁腺功能亢进症的临床价值[J].中国继续医学教育,2015,7(4):183-184.
[15]朱进,柴雪红.高频彩超联合~(99m)Tc-MIBI双时显像诊断原发性甲状旁腺功能亢进的价值[J].中国医学工程,2015,23(1):17-18.
[2]黎俊,李莉,林华.~(99m)Tc-MIBI双时相显像与SPECT/CT融合显像对原发性甲状旁腺功能亢进症的诊断价值[J].医学影像学杂志,2017,27(6):1063-1067.
[3]李玮朋,王原,高茜,等.正常血钙型原发性甲状旁腺功能亢进症漏诊报告并文献复习[J].临床误诊误治,2017,30(2):45-47.
[4]王军,张宏,安宁,等.99m Tc-MIBI核素显像误诊为甲状旁腺腺瘤1例[J].中国医学文摘:耳鼻咽喉科学,2016,31(6):325-327.
[5]龚志琰.超声在甲状旁腺功能亢进症诊断及术前定位中应用[J].临床军医杂志,2016,44(10):1070-1073.
[6]刘晓杰,桂文来,蒋灵军.99m Tc-MIBI联合99m Tc-MDP显像诊断甲状旁腺功能亢进症的价值[J].世界最新医学信息文摘,2016,16(82):6-7.
[7]赵银龙,宋晓良,郝婷婷,等.99m Tc-MIBI双时相显像诊断原发性异位甲状旁腺亢进性腺瘤伴对侧甲状腺微小乳头状癌1例[J].中国实验诊断学,2016,20(9):1592-1594.
[8]于军霞,欧阳兆强,张霞,等.甲状旁腺腺瘤并原发性甲状旁腺功能亢进症临床特点及误诊原因分析[J].临床误诊误治,2015,28(11):21-25.
[9]许小飞,刘雅洁,张伟晓,等.288例肾功能不全继发甲状旁腺功能亢进核素扫描图像分析[J].南京医科大学学报:自然科学版,2015,35(9):1259-1261.
[10]赵敏,李新辉,黄金,等.SPECT/CT在甲状旁腺功能亢进中的诊断价值及其与多种影像学方法的比较[J].中南大学学报:医学版,2015,40(9):1016-1022.
[11]王晨,赵志刚,郑瑞芝.原发性甲状旁腺功能亢进39例诊断及治疗分析[J].中华实用诊断与治疗杂志,2015,29(5):458-459.
[12]李征.~(99m)Tc-MIBI SPECT-CT显像在纵隔内异位甲状旁腺诊治中的应用价值[J].检验医学与临床,2015,12(6):765-767.
[13]刘洋,朱莹莹,史莹,等.原发性甲状旁腺功能亢进症的诊治[J].中国实验诊断学,2015,19(2):230-232.
[14]张洋.探讨核医学诊断原发性甲状旁腺功能亢进症的临床价值[J].中国继续医学教育,2015,7(4):183-184.
[15]朱进,柴雪红.高频彩超联合~(99m)Tc-MIBI双时显像诊断原发性甲状旁腺功能亢进的价值[J].中国医学工程,2015,23(1):17-18.