摘要
应了^（99m）Tc-MIBI进行了甲状旁腺显像,并对方法学进行了探讨。10例患者经临床、生化确诊为原发甲旁亢,但均未触及增大的甲状旁腺或甲状腺。其中7例在应用^（99m）Tc-MIBI和^（99m）Tc两种示踪剂分别进行甲状旁腺显像和甲状腺显像,3例仅用^（99m）Tc-MIBI,但在显像过程中给予了过氯酸盐。在静泳注射^（99m）Tc-MIBI后不同时间采集图象并选用产P/T值（甲状旁腺计数/甲状腺计数）做参数,以了解示踪剂的代谢及确定最佳显像时间。10例患者经手术共摘除12枚肿大的甲状旁腺,病理证实10枚为甲状旁腺腺瘤,2枝为甲状旁腺增生,B超检查9例中发现2枚腺瘤,CT检查8例共发现3枚腺瘤,核素显像10例患者各发现腺瘤一个,其阳性部位与手术所见完全吻合。尽管例数较少,但初步看,此方法简便、准确,对于原发甲旁亢的定位诊断确有临床价值。
Parathyroid scanning was performed with 99mTc-MIBI in 10 patients who had clinical and biochemical findings suggesting primary hyperparathyroidism but had no enlarged parathyroid or palpable thyroid. Seven cases were scanned with both 99mTc-MIBI and 99mTc and three cases with 99mTc-MIBI only but perchlorate was administered during the scan. A series of images were acquired for all cases at different time intervals after 99mTc-MIBI was injected intravenously to allow the dynamic studies. The P/T ratios (counts in parathyroid counts in thyroid)were also designed to see whether the agent had different uptakes and metabolic characteristics in parathyroid and thyroid tissues from 99mTc-MIBI. Surgical finding and histological examination were taken as gold standard against which US. CT and scintigraphy were judged. Finally, 10 adenomas found exactly at the sites predicted by scintigraphy and 2 hyperplastic glands were removed from the 10 patients. Ten of 10 99mTc-MIBI scans, two of 9 US scans and three of 8 CT scans were positive for a parathyroid adenoma, but 2 hyperplastic glands were missed by all of the three methods. It was shown that the suitable time for imaging was at 1h-2h or 30min-1h(if perchlorate was used) after 99mTc-MIBI was given, so as to render both adenoma and background clear. Despite the limited number of cases, the preliminary experience thus suggests that 99mTc-MIBI scintigraphy maybecome the technique of choice for the localization of hyperparathyroidism in stead of 21Tl.
出处
《中华内分泌代谢杂志》
CAS
CSCD
北大核心
1996年第2期93-96,共4页
Chinese Journal of Endocrinology and Metabolism
关键词
甲状旁腺
机能亢进
放射性核素
诊断
Hyperparathyroidism Adenoma,parathyroid 99m'Tc-MIBI Radioactive scintigraphy
