摘要
目的探讨MRI在原发性甲状旁腺功能亢进(primary hyperparathyroidism,PHPT)诊断中的应用价值。方法回顾性分析2010年1月至2017年6月在本院临床诊断为PHPT并经手术病理证实的30例患者(32个病灶)的术前影像资料。其中28例行MRI平扫和(或)增强检查,29例行^(99m)Tc-甲氧基异丁基异腈(MIBI)双时相显像,28例行超声检查,27例患者同时行MRI与核素显像。以病理结果为金标准评估三种影像检查方法及MRI联合^(99m)Tc-MIBI SPECT诊断PHPT的准确率、灵敏度、特异度、阳性预测值、阴性预测值以及与病理结果的一致性。结果 30例患者中甲状旁腺腺瘤28例(30个病灶),甲状旁腺增生2例(2个病灶)。三种影像方法及MRI联合^(99m)Tc-MIBI SPECT诊断PHPT的准确率、灵敏度、特异度、阳性预测值、阴性预测值及一致性检验所得Kappa值分别为:MRI为94.69%、83.33%、98.80%、96.15%、94.25%、0.858;^(99m)Tc-MIBI SPECT双时相显像为94.87%、86.21%、97.73%、92.59%、95.56%、0.859;超声为89.38%、70.00%、96.39%、87.50%、89.89%、0.709;联合应用MRI与^(99m)TcMIBI SPECT为99.08%、96.55%、100.00%、100.00%、98.77%、0.976。结论 MRI可作为PHPT病变定位诊断的重要辅助检查方法,联合MRI与^(99m)Tc-MIBI SPECT双时相显像可更好地进行病变的术前定位及诊断。
Objective To evaluate the value of MR1 in diagnosing primary hyperparathyroidism（PHPT）, and analyze different results of multiple imaging modalities in the diagnosis of parathyroid lesion. Method Totally 32 PHPT lesions in 30 patients with surgery resection were analyzed retrospectively. There were 28 cases with MRI scan. （with.or without, enhancement）;99m 29 cases with 99mTc-MI13I dual-phase SPECT scan, 28 cases with ultrasonographical exam; 27 cases with combination of MRI and Tc-MIBI dual-phase SPECT examination. Using pathological results as the gold standard, the accuracy, sensitivity, specificity, positive predictive value, negative predictive value and Kappa value of the three imaging modalities.Result There were 28 cases of parathyroid adenoma （30 lesions）; 2 cases of parathyroid hyperplasia （2 lesions）. The accuracy, sensitivity, specificity, positive predictive value, negative predictive value, Kappa value-MRI were 94.69%, 83.33%, 98.80%, 96.15%, 94.25%, 0.858; 99mTc-MI]31 dual-phase SPECT were 94.87%, 86.21%, 97.73%, 92.59%, 95.56%, 0.859; ultrasonography were 89.38%, 70.00%, 96.39%, 87.50%, 89.89%, 0.709; combination of MRI and 99 Tc-MIBI dual-phase SPECT examination were 99.08%, 96.55%, 100.00%, 100.00%, 98.77%, 0.976. Conclusion MRI is an effective tool for diagnosis of PHPT.Combination of MRI and 99mTc-MIBI dual-phase SPECT examination can provide better diagnostic accuracy of PHPT.
作者
宋明慧
岳云龙
金延方
郭劲松
左利利
SONG Ming-hui;YUE Yun-long;JIN Yan-fang;GUO Jin-song;ZUO Li-li(Department of MRI, Beijing Shijitan Hospital, Capital Medical University, Beoing 100038, China)
出处
《中国医刊》
CAS
2018年第1期64-67,共4页
Chinese Journal of Medicine
