Chinese General Practice ›› 2023, Vol. 26 ›› Issue (36): 4552-4557.DOI: 10.12114/j.issn.1007-9572.2022.0276-1

• Article • Previous Articles     Next Articles

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

  

  1. 1. Department of Ultrasound, First Affiliated Hospital, School of Medicine, Shihezi University, Shihezi 832008, China
    2. NHC Key Laboratory of Prevention and Treatment of Central Asia High Incidence Diseases, Shihezi 832008, China
  • Received:2022-12-19 Revised:2023-04-05 Published:2023-12-20 Online:2022-10-24
  • Contact: LI Jun

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

  

  1. 1.832008 新疆维吾尔自治区石河子市,石河子大学医学院第一附属医院超声科
    2.832008 新疆维吾尔自治区石河子市,国家卫健委中亚高发病防治重点实验室
  • 通讯作者: 李军
  • 作者简介:
    作者贡献:马金梅负责文章的构思与设计,撰写论文;刘文负责研究的实施与可行性分析;马金梅、张晓梅进行数据收集;刘文、张晓梅负责数据整理;曹春莉负责统计学处理;马金梅、曹春莉负责结果的分析与解释;马金梅、康燕飞进行论文的修订;康燕飞负责文章的质量控制及审校;李军对文章整体负责,监督管理。
  • 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)

Abstract:

Background

Different pathological types of parathyroid lesions determine the choice of treatment and prognosis. Ultrasound and 99mTc-MIBI scintigraphy 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 99mTc-MIBI scintigraphy 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

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99mTc-MIBI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的超声及核素表现,而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(PH)与甲状旁腺腺瘤(PA)的常规超声及99mTc-MIBI显像特点,探讨常规超声与99mTc-MIBI显像鉴别诊断PH与PA的价值。

方法

选取2016年2月—2022年3月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99mTc-MIBI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

常规超声鉴别诊断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)(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