Diagnostic value of dual-phase 99Tcm-MIBI scintigraphy in patients with ectopic secondary hyperparathyroidism
10.3760/cma.j.issn.2095-2848.2016.05.011
- VernacularTitle:99Tcm-MIBI延迟显像对继发性甲状旁腺功能亢进症异位病灶的诊断价值
- Author:
Xiaofei XU
;
Yajie LIU
;
Weixiao ZHANG
;
Bing TANG
- Publication Type:Journal Article
- Keywords:
Hyperparathyroidism,secondary;
Tomography,emission-computed,single-photon;
Tomography,X-ray computed;
MIBI
- From:
Chinese Journal of Nuclear Medicine and Molecular Imaging
2016;36(5):431-435
- CountryChina
- Language:Chinese
-
Abstract:
Objective To compare the diagnostic value of dual-phase 99Tcm-MIBI scintigraphy and color Doppler ultrasonography for localizing ectopic parathyroid lesions in patients with HPT secondary to chronic renal failure (CRF-HPT).Methods Medical records of 368 CRF-HPT patients (204 males,164 females,age range:12-76 years) from January 2011 to April 2015 were retrospectively analyzed.Pathological results was used as the gold standard for the diagnosis of HPT.The sensitivity and specificity of dualphase 99Tcm-MIBI scintigraphy and color Doppler ultrasonography for the diagnosis and localization of ectopic parathyroid lesions were studied and compared by x2 test.Results A total of 1 398 positive lesions were found in 356 patients by dual-phase 99Tcm-MIBI scintigraphy,and 54 ectopic lesions occupying 3.9%(54/1 398) of positive lesions were detected by delayed planar imaging or SPECT/CT fusion imaging in 45 patients.Most of them (n =53) were confirmed by pathology.While only 966 positive lesions were found in 254 patients and no ectopic lesions were identified by color Doppler ultrasonography.The diagnostic sensitivity and specificity of dual-phase 99Tcm-MIBI scintigraphy for CRF-HPT lesions were 97.2%(1 375/1 415) and 53.1%(26/49),respectively.The corresponding parameters of color Doppler ultrasonography were 66.4% (940/1 415) and 46.9% (23/49),respectively.The specificity of ectopic lesion localization by radionuclide imaging was 98.1% (53/54).The accuracy of dual-phase 99Tcm-MIBI scintigraphy was significantly higher than that of color Doppler ultrasound in lesion localization (x2 =20.8,P < 0.05).Conclusion Compared to color Doppler ultrasonography,99Tcm-MIBI scintigraphy is more sensitive in identifying the positive lesions and more specific in localizing the ectopic parathyroid lesions in patients with CRF-HPT.