Additional role of 99mTc-MIBI SPECT-CT imaging in preoperative localization of parathyroidectomy-clinical analysis of 359 patients with secondary hyperparathyroidism
10.3760/cma.j.issn.1001-7097.2017.02.002
- VernacularTitle:99mTc-MIBI SPECT-CT技术在甲状旁腺切除术前定位诊断中的增益价值
- Author:
Ming ZENG
;
Wei LIU
;
Ningning WANG
;
Changying XING
;
Huijuan MAO
;
Xiangbao YU
;
Xiaoming ZHA
;
Bin SUN
;
Guang YANG
;
Bo ZHANG
;
Chun OUYANG
;
Xiaolin LYU
;
Ling WANG
;
Qing MA
;
Yanyan PAN
- Keywords:
Hyperparathyroidism,secondary;
Parathyroidectomy;
Tomography,emission-computed,single photon;
Dual-phase 99mTc sestamibi scintigraphy
- From:
Chinese Journal of Nephrology
2017;33(2):86-91
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the additional role of 99mTc-MIBI SPECT-CT imaging before parathyroidectomy (PTX) for secondary hyperparathyroidism (SHPT) patients.Methods A total of 359 SHPT patients from the First Affiliated Hospital of Nanjing Medical University were enrolled in the study from April 2011 to January 2016.Patients were divided into two groups according to the difference of 99mTc-MIBI imaging techniques preoperatively.Patients in group A had dual-phase 99mTc-sestamibi parathyroid scintigraphy performed only.Patients in group B had SPECT-CT parathyroid scintigraphy added in the early phase.With the parathyroid glands confirmed by pathology after operation being the referencc,scnsitivity,specificity,consistency and surgical success rates of the patients in two groups were compared.Results 359 patients (166 men and 193 women) were enrolled,among which 339 on hemodialysis and 20 on peritoneal dialysis.The average age of those patients was (45.90± 11.20) years and median dialysis age was 84 (60.0,120.0) months.Total detection sensitivity,specificity,consistency in group A (169 patients) were 65.54％,56.52％,65.24％ and in group B (190 patients) were 73.84％,84.62％,74.21％ respectively.Total sensitivity and consistency were higher in group B than those in group A (P ＜ 0.01),while no difference in total specificity was observed between two groups (P=0.055).In group A,detection sensitivity of parathyroid glands were 47.56％,77.44％,57.14％ and 79.88％ in right upper gland (RU),right lower gland (RL),left upper gland (LU) and left lower gland (LL) respectively.Consistency in group A were 48.52％,77.51％,56.21％ and 78.70％ respectively.In group B,sensitivity were 58.33％,83.78％,69.78％ and 82.89％ in RU,RL,LU and LL respectively.Consistency in group B were 59.47％,84.21％,70.53％ and 82.63％ respectively.Sensitivity and consistency of upper glands were lower than lower glands in both groups (P ＜ 0.01).When SPECT-CT was added,sensitivity and consistency of upper glands for both sides were higher in group B than those in group A,while no difference of surgical success rates was found between two groups (87.57％ vs 92.63％,P=0.107).Conclusion 99mTc-MIBI SPECT-CT can be combined with anatomic image effectively and increase the sensitivity and consistency of total and upper parathyroid glands.It can also make the accurate location of the lesions,which improves the efficiency of the operation.
