摘要
目的：着重论述核医学检查方法在原发性甲状旁腺功能亢进（原发性甲旁亢）中的应用。方法：经临床和手术证实为原发性甲旁亢的22例患者（腺瘤19例，增生3例），均进行了血清甲状旁腺激素（PTH）免疫放射分析检测及^99Tc^m-MIBI双时相甲状旁腺显像，15例做了^99Tc^mO^-4甲状腺显像，8例做了^99Tc^m-MDP全身骨显像。结果：所有患者血清PTH（428.21±256.48)均明显高于正常值，腺瘤患者增高更显著（781.83±194.56)。^99Tc^m-MIBI双时相显像检测腺瘤病灶的灵敏度初始相和延迟相分别为84.2%和100%，检测增生病灶的灵敏度仅为33.3%。13例甲状腺显像正常，2例显示冷结节。7例呈异常影像改变，骨影像变化程度与病程有关。结论：血清PTH免疫放射检测和^99Tc^m-MIBI双时相显像方法是定性和定位诊断原发性甲旁亢的灵敏手段；^99Tc^m-MIBI双时相法检测增生病灶的能力有限；甲状腺显像和全身骨显像有助于提高原发性甲旁亢的诊断符合率及病情和病程的判断力。
Objective\ To expound emphatically the application of nuclear medical examination in primary hyperparathyroidism.Methods\ 22 patients (19 adenomas,3 hyperplasia) with primary hyperparathyroidism confirmed by clinical examination and surgery underwent the detection of parathormone (PTH) by immunoradiometric assay (IRMA) and double phase 99 Tc m-MIBI parathyroid imaging,of whom 15 performed 99 Tc mO - 4 thyroid imaging and 8 99 Tc m-MDP bone imaging.Results\ The level of serum PTH in all patients (428.21±256.48) was significantly higher as compared to normal value and in cases with adenomas (781.83±194.56) was markedly elevated.The sensitivity of 99 Tc m-MIBI early and delayed phase imaging in detecting lesions of parathyroid adenomas was 84.2% and 100%,respectively.The sensitivity in detecting lesions of hyperplasia was only 33.3%.With 99 Tc m-O - 4 thryoid imaging,the cold nodules were present in 2 and normality in 13.As to bone imaging,the scans were abnormal in 7.Their severities on bone scintigraph were correlated with the duration of the disease.Conclusions\ The level of serum PTH detected by IRMA and double phase 99 Tc m-MIBI parathyroid imaging are both sensitive methods in qualitative diagnosis and localization of hyperthyroidism. 99 Tc m-MIBI imaging has limited value for detecting the hyperplasia.The thyroid and bone imaging may well improve the diagnostic sensitivity and accuracy,and reflect the stage and progress of hyperparathyroidism.
出处
《医师进修杂志》
北大核心
2001年第7期16-18,共3页
Journal of Postgraduates of Medicine
