摘要
目的肾性甲状旁腺机能亢进是继发性骨质疏松中的一种,随着透析技术的普及而增多的严重影响患者生活质量的疾病,外科手术治疗可以迅速缓解病情。探讨联合应用高频彩超和99mTc-MIBI双时相显像技术,在甲状旁腺切除术(Parathyroidectomy,PTX)术前定位诊断中的价值。方法回顾性分析38例进行了PTX患者的高频彩超和99mTc-MIBI双时相显像结果,与术后病理结果进行比较,评价二者在术前诊断和定位中的敏感性和特异性。结果高频彩超的敏感性和特异性分别为56.9%和78.6%;而MIBI为53.9%和80.0%。统计学分析显示二者之间无显著性差异(P>0.05)。在所有38例患者中,外科共切除的甲状旁腺腺体127枚,其中高频彩超检测到的占65枚(51.2%);MIBI检测到68枚的占(53.5%)。联合应用高频彩超和MIBI检测甲状旁腺的数目为82枚(64.6%),较单用其中之一显现率更高(P<0.05)。高频彩超和MIBI发现的下极甲状旁腺的数目较上级显现率更高(P<0.05),但二者之间无显著性差异。结论联合应用高频彩超和99mTc-MIBI双时相显像技术可提高继发性甲旁亢患者术前定位诊断的敏感性和特异性,对指导外科手术有较高价值。
Objective Renal hyperparathyroidism is a kind of secondary osteoporosis. To investigate the effects of combination of ultrasound and 99mTc-MIBI parathyroid seintigraphy （MIBI） in preoperative diagnosis and location for renal hyperparathyroidism patients. Methods 38 patients with renal hyperparathyroidism underwent parathyroideetomy. The sensitivity and specificity of ultrasound and seintigraphy related to pathological results were determined. Results The sensitivity and the specificity of and ultrasound were 56.9% and 78.6% , and the scintigraphy were 53.9% and 80.0% , respectively. There was no significantly difference between two procedures （ P 〉 0.05）. 65 of 127 parathyroid glands （51.2%） from surgical resection were detected by the ultrasound, and 68 of 127 parathyroid glands （53.5%） by the seintigraphy. The sensitivity of combined techniques was 64. 6% （82/127）, which was greater than that of either ultrasound or scintigraphy alone （ P 〈 0.05 ）. Tthe superior localization of glands were easier deetected than others inferior by the ultrasound or scintigraphy （P 〈 0. 05 ）. Conclusion The combination of ultrasound and scintigraphy showed a higher sensitivity than that of either ultrasoound or seintigraphy alone in renal hyperparathyroidism （SHPT） patients and there were a valuable preoperative diagnosis and location.
出处
《中国骨质疏松杂志》
CAS
CSCD
2010年第8期580-583,共4页
Chinese Journal of Osteoporosis
基金
首都医学发展基金资助项目(2009-3023)
