摘要
目的探讨^(99m)Tc-甲氧基异丁基异腈(MIBI)单光子发射计算机断层成像术(SPECT)/电子计算机X线断层摄影术(CT)双时相显像联合血清甲状旁腺激素(PTH)及血钙水平在原发性甲状旁腺功能亢进症(PHPT)诊断中的临床价值。方法回顾性分析2022年3月至2024年3月在邢台市中心医院就诊的102例疑似PHPT患者,其中41例经手术病理确诊为PHPT阳性,设为PHPT阳性组,61例为PHPT阴性,设为PHPT阴性组。所有患者术前均接受^(99m)Tc-MIBI SPECT/CT双时相显像,并检测血钙与血清PTH水平。通过与手术病理结果对比,评估各项诊断方法的敏感度、特异度、准确性及诊断一致性。采用受试者操作特征(ROC)曲线分析^(99m)Tc-MIBI SPECT/CT双时相显像及血钙、PTH水平诊断PHPT的价值。结果PHPT阳性组患者的血钙及PTH水平分别为(2.59±0.38)mmol/L、(132.82±34.68)pg/mL,均显著高于PHPT阴性组[(2.38±0.41)mmol/L、(79.26±18.43)pg/mL],差异均有统计学意义(P<0.05)。单独检测血钙、血清PTH和^(99m)Tc-MIBI SPECT/CT显像的Kappa值分别为0.318、0.397和0.777,联合血钙与PTH的Kappa值为0.514,3者联合的Kappa值为0.918,显示联合诊断的准确性明显提高。ROC曲线分析显示,3者联合的AUC为0.964,敏感度为92.68%,特异度为98.36%,准确性为96.08%,明显优于单独检测。结论^(99m)Tc-MIBI SPECT/CT双时相显像联合血清PTH及血钙水平能显著提高PHPT的诊断精度,具有较高的敏感度、特异度及准确性,对PHPT的临床诊断具有重要意义。
Objective To investigate the clinical value of ^(99m)Tc-methoxyisobutylisophthalate(MIBI)single-photon emission computed tomography(SPECT)/computerized tomography(CT)dual-phase imaging combined with serum parathyroid hormone(PTH)and serum calcium levels in the diagnosis of primary hyperparathyroidism(PHPT).Methods A retrospective analysis was performed on 102 patients with suspected PHPT admitted to Xingtai Central Hospital from March 2022 to March 2024.Among them,41 cases were confirmed PHPT positive,which were classified as the PHPT positive group,and 61 cases were negative by surgical pathology,which were classified as the PHPT negative group.All patients underwent ^(99m)Tc-MIBI SPECT/CT dual-phase imaging before surgery,and serum calcium and PTH levels were detected.The sensitivity,specificity,accuracy and diagnostic consistency of each diagnostic method were evaluated by comparing with surgical pathological results.The receiver operator characteristic(ROC)curve was used to analyze the value of ^(99m)Tc-MIBI SPECT/CT dual-phase imaging and serum calcium and PTH levels in the diagnosis of PHPT.Results The levels of serum calcium and PTH in the PHPT positive group were(2.59±0.38)mmol/L and(132.82±34.68)pg/mL,respectively,which were significantly higher than those in the PHPT negative group[(2.38±0.41)mmol/L,(79.26±18.43)pg/mL],the differences were statistically significant(P<0.05).The Kappa values of single detection of serum calcium,serum PTH and ^(99m)Tc-MIBI SPECT/CT were 0.318,0.397 and 0.777,respectively.The Kappa value of combination of serum calcium and PTH was 0.514,and the Kappa value of combination of the three was 0.918,indicating that the accuracy of combined diagnosis was significantly improved.ROC curve analysis showed that the AUC of the combination of the three was 0.964,the sensitivity was 92.68%,the specificity was 98.36%,and the accuracy was 96.08%,which was significantly better than that of single detection.Conclusion ^(99m)Tc-MIBI SPECT/CT dual-phase imaging combined with serum PTH and calcium levels can significantly improve the diagnostic accuracy of PHPT,with high sensitivity,specificity and accuracy,which is of great significance for the clinical diagnosis of PHPT.
作者
毕甜甜
左玮玮
张秀婷
马子媛
BI Tiantian;ZUO Weiwei;ZHANG Xiuting(Department of Nuclear Medicine,Xingtai Central Hospital,Xingtai Hebei 054000,China)
出处
《临床和实验医学杂志》
2025年第21期2326-2329,共4页
Journal of Clinical and Experimental Medicine
基金
河北省卫生健康委员会科技计划项目(编号:20220533)。
