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目的 :探讨肾功能不全继发甲状旁腺功能亢进患者临床病理与99mTc-MIBI双时相显像特征的关系。方法 :收集与分析本院肾功能不全继发甲状旁腺功能亢进患者99mTc-MIBI双时相显像检查的临床与影像资料的相关性,总结该检查的临床诊断价值及临床注意事项。结果:288例患者中核素扫描阳性284例(98.6%),阳性病灶1 104个,平均3.83个/例;其中通过加扫延迟平面显像和Hawkeye CT扫描获得异位病灶35处;另有51个病灶核素扫描阴性而通过彩色多普勒超声发现。核素扫描对继发性甲状旁腺功能亢进病灶的定位灵敏度为96.2%(1 077/1 119),特异度为97.6%(1 077/1 104),其早期相和延迟相T/NT值与患者术前甲状旁腺素和碱性磷酸酶值呈正相关。结论:99mTc-MIBI双时相显像对继发性甲状旁腺功能亢进病灶不仅具有良好的定位诊断价值,且能反映甲状旁腺腺体的功能水平和疾病严重程度。
Objective: To investigate the relationship between clinicopathologic features and 99m Tc-MIBI bi-temporal imaging in patients with secondary hyperparathyroidism after renal insufficiency. Methods: The clinical and imaging data of 99mTc-MIBI double-phase imaging in patients with hyperparathyroidism secondary to renal dysfunction were collected and analyzed. The clinical diagnostic value and clinical precautions were summarized. Results: Of the 288 patients, 284 (98.6%) were positive for radionuclide scanning and 1 104 were positive, with an average of 3.83 per patient. Thirty-five ectopic lesions were obtained by scanning delayed planar imaging and Hawkeye CT scan. Fifty-one lesions were negative for nuclear scintigraphy and were detected by color Doppler sonography. The sensitivity of radionuclide scanning in detecting secondary hyperparathyroidism was 96.2% (1 077/1 119) and specificity was 97.6% (1 077/1 104). The early phase and delayed phase T / NT values And patients preoperative parathyroid hormone and alkaline phosphatase value was positively correlated. Conclusion: 99mTc-MIBI dual-phase imaging not only has good diagnostic value for the diagnosis of secondary hyperparathyroidism, but also can reflect the functional level of the parathyroid gland and the severity of the disease.