中国全科医学

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常规超声与99mTc-MIBI显像在甲状旁腺增生与甲状旁腺腺瘤鉴别诊断中的价值

马金梅1,刘文1,曹春莉1,康燕飞1,张晓梅1,李军1,2*   

  1. 1. 石河子大学医学院第一附属医院超声科,新疆石河子 832008;2. 新疆医学大学省部共建中亚高发病成因与防治国家重点实验室,新疆乌鲁木齐 830054
  • 基金资助:
    中国医学科学院中央级公益性科研院所基本科研业务费专项资金资助项目(2020-PT330-003);兵团科技攻关项目(2019DB012)

Ultrasound and 99mTc-MIBI Scintigraphy in Differentiating between Parathyroid Hyperplasia and Parathyroid Adenoma

MA Jin-mei1, LIU Wen1, CAO Chun-li1, KANG Yan Fei1, ZHANG Xiao Mei1 ,Yan Fei1, LI Jun1、2*   

  1. 1Department of Ultrasound,the First Affiliated Hospital of Medical College of Shihezi University,Shihezi, Xinjiang 832008, China; 2NHC Key Laboratory of Prevention and Treatment of Central Asia High Incidence Diseases(First Affiliated Hospital, School of Medicine, Shihezi University);
    *Corresponding Author E-mail:1287424798@qq.com

摘要: 背景 甲状旁腺病变的不同病理类型决定其治疗方案的选择及预后,超声及核素显像技术在诊断甲状旁腺病变中已广泛应用。目前已有研究表明,不同病理分型的甲状旁腺病变有不同超声及核素表现,但是如何从诸多超声特征及核素图像中提取各型病变的特征性指标是目前研究的难点。目的 比较甲状旁腺增生(Parathyroid Hyperplasia,PH)与甲状旁腺腺瘤(Parathyroid Adenoma,PA)的常规超声及核素显像特点,探讨常规超声与核素显像鉴别诊断PH与PA的价值。方法 选取2016年2月至2022年3月期间石河子大学医学院第一附属医院收治的150例(共199个结节)行甲状旁腺切除的患者资料,术前所有患者均行甲状旁腺常规超声检查及99mTc-MIBI显像,以术后病理检查结果为金标准,比较PH和PA的常规超声及核素显像差异,采用受试者工作特征曲线(ROC曲线)分析常规超声与99mTc-MIBI显像对PH、PA的鉴别诊断价值。结果 常规超声诊断PH、PA的灵敏度、特异度、准确率、ROC曲线下面积(82.14%,89.51%,87.43%,0.885)均高于99mTc-MIBI显像(50.00%、64.34%、60.30%、0.775),差异有统计学意义(P<0.05)。结论 常规超声与99mTc-MIBI显像对PA、PH均有一定诊断价值,且常规超声对PA、PH的鉴别诊断效能优于99mTc-MIBI显像。

关键词: 甲状旁腺疾病, 常规超声, 99mTc-MIBI显像, 甲状旁腺增生, 甲状旁腺腺瘤

Abstract: Background Different pathological types of parathyroid lesions determine the choice of treatment and prognosis. Ultrasound and radionuclide imaging techniques have been widely used in the diagnosis of parathyroid lesions. Studies have shown that ultrasound and radionuclide manifestations of parathyroid lesions differ by the pathological type,but how to extract the characteristic indices of various types of parathyroid lesions from many ultrasound features and radionuclide scanning images is a difficulty of current research. Objective To compare the value of ultrasound versus 99mTc-MIBI scintigraphy in differentiating between parathyroid hyperplasia(PH)and parathyroid adenoma(PA)by analyzing the features of PH and PA measured by them. Methods One hundred and fifty patients with 199 thyroid lesions in total who underwent parathyroidectomy in First Affiliated Hospital,School of Medicine,Shihezi University from February 2016 to March 2022 were selected. Parathyroid ultrasound and 99mTc-MIBI scintigraphy were performed before operation,and the detected results by them were comparatively assessed with postoperative pathological findings as the gold standard for reference. The receiver operating characteristic(ROC)analysis was used to estimate the value of the two modalities in differentiating between PH and PA. Results Compared with 99mTc-MIBI scintigraphy,ultrasound had higher sensitivity(82.14% vs 50.00%),specificity(89.51% vs 64.34%),accuracy (87.43% vs 60.30%)and larger area under the ROC curve(0.885 vs 0.775)(P<0.05)in differentiating between PH and PA,. Conclusion Both ultrasound and 99mTc-MIBI scintigraphy could differentiate between PA and PH,but the performance of ultrasound was better.

Key words: Parathyroid diseases, ultrasound, 99mTc-MIBI imaging, Parathyroid hyperplasia, Parathyroid adenoma