副甲状腺~(99)TC~M-MIBI SPECT/CT画像の原発性副甲状腺機能亢進症の診断における利得価値【JST・京大機械翻訳】

Objective To investigate the incremental value of 99Tcm-MIBI SPECT/CT imaging in the preoperative diagnosis of PHPT. Methods Forty-one patients (13 males, 28 females, age range: 14-82 (50.0±13.2) years)with PHPT were retrospectively enrolled. 99Tcm-MIBI dual-phase planar scan, SPECT/CT imaging, CT and neck ultrasound were performed before surgery. All patients had pathological results. McNemar χ2 test was used to compare the detection rates of the four imaging methods. ROI method was applied to calculate the uptake ratio (T/NT) and Pearson correlation analysis was used to evaluate correlation between T/NT and serum intact PTH, Ca, the lesion volume measured after parathyroidectomy. Results A total of 42 parathyroid lesions were confirmed by pathology. There were 39 patients with parathyroid adenoma (2 with double adenomas, and 37 with single adenoma containing 2 ectopic adenomas) and 1 patient with parathyroid carcinoma. The detection rate of planar scan, SPECT/CT imaging, CT and neck ultrasound were 78.0%(32/41), 92.7%(38/41), 73.2%(30/41) and 70.7%(29/41)respectively. Detection rate of SPECT/CT imaging was significantly higher than that of planar scan, CT or ultrasonography (χ2=4.17, 4.90, 5.82, all P 0.05). Detection rates of CT and ultrasonography were not significantly different either (χ2=1.90, P>0.05). T/NT in delayed planar imaging were significantly correlated with PTH, Ca and the lesion volume measured after parathyroidectomy (r=0.56, 0.54, 0.56, all P<0.01). Conclusions Compared with 99Tcm-MIBI dual-phase planar scan, CT and ultrasonography, SPECT/CT imaging could be of important clinical value for preoperative localization of PHPT because of its higher detection rate and accurate anatomical localization ability. Key words: Hyperparathyroidism, primary; Tomography, emission-computed, single-photon; Tomography, X-ray computed; MIBI