甲状旁腺功能亢进症患者血清PTH水平与99mTc-MIBI
SPECT/CT双时相显像的相关性研究

doi:10.12117/jccmi.2020.03.006

Abstract
Figure/Table
References (14)
Related Citation (15)

Download: PDF (0 KB) HTML (1 KB)
Export: BibTeX | EndNote (RIS)

Abstract Objective: To analyze the characteristics of 99mTc-MIBI SPECT/CT dual-phase imaging in patients with hyperparathyropathy, combined with the serum PTH levels, to explore the correlation with MIBI imaging results. Methods: Retrospective analysis of MIBI imaging data of 143 patients with elevated serum PTH which were suspected of hyperparathyropathy from June 2016 to April 2019. Results: ①The median PTH levels of primary(PHPT) and secondary(SHPT) hyperparathyropathy were 110(65.7~998.5) pg/mL and 1 725(368.3~3 533.0) pg/mL, respectively. There was significant difference between the two groups(Z=-8.79, P=0.000), SHPT group was significantly higher than that in PHPT group.②The positive rates of MIBI planar imaging and tomographic imaging were 57.3% and 68.5%, respectively. ③According to the MIBI imaging results, the PHPT patients were divided into positive group and negative group. The serum PTH levels were different between the two groups(Z=-5.32, P=0.00). The level of PTH was significantly higher in positive group. ④The age, gender and PTH value were taken as independent variables, and the results of tomographic imaging were used as dependent for logistic regression analysis. The influencing factor in PHPT group was PTH value(OR: 1.014, 95%CI: 1.005~1.024, r=0.52, P<0.00). Correlation coefficient r=0.52, P=0.00. No related factors was found in SHPT group. ⑤The ROC curves of planar imaging and tomographic imaging in PHPT group were drawn. The areas under the curve were 0.75 and 0.81, the cutoff values of PTH were 115.6 and 112.9, and the positive predictive values were 75.0% and 86.5%, respectively. Conclusion: The level of serum PTH in patients with secondary hyperthyroidism was higher than that in patients with primary hyperthyroidism. The level of serum PTH was correlated with the results of MIBI imaging in patients with primary hyperthyroidism. The higher level of serum PTH means the higher positive rate of MIBI imaging. The cutoff values were 115.6 pg/mL and 112.9 pg/mL, and the corresponding positive predictive values were 75.0% and 86.5%, respectively.

Key words： Hyperparathyroidism Tomography, emission-computed, single-photon Technetium tc 99m sestamibi

Received: 27 June 2019

PACS:	Ｒ582.1
	Ｒ817.4

	Service

	E-mail this article
	Add to my bookshelf
	Add to citation manager
	E-mail Alert
	RSS
	Articles by authors
	ZHOU Jian-li
	WANG Jian
	ZHU Fu-qiang

Cite this article:

ZHOU Jian-li,WANG Jian,ZHU Fu-qiang. Correlation between serum PTH level and 99mTc-MIBI SPECT/CT dual-phase imaging in patients with hyperparathyropathy[J]. JOURNAL OF CHINA MEDICAL IMAGING, 2020, 31(3): 171-174.

URL:

http://www.jccmi.com.cn/EN/10.12117/jccmi.2020.03.006 OR http://www.jccmi.com.cn/EN/Y2020/V31/I3/171

[1]Bandeira F, Griz L, Chaves N, et al. Diagnosis and management of primary hyperparathyroidism—a scientific statement from the Department of Bone Metabolism, the Brazilian Society for Endocrinology and Metabolism[J]. Arq Bras Endocrinol Metabol, 2013, 57(6): 406-424. [2]Bilezikian JP, Brandi ML, Eastell R, et al. Guidelines for the management of asymptomatic primary hyperparathyroidism: summary statement from the fourth international workshop[J]. J Clin Endocrinol Metab, 2014, 99(3): 3561-3569. [3]郭林，刘玉婷，金刚，等. 99Tcm-MIBI SPECT/CT双时相显像联合血清甲状旁腺激素测定对原发性甲状旁腺功能亢进症的诊断价值[J]. 标记免疫分析与临床，2018，25（7）：925-928. [4]曹景佳，李亚明. SPECT/CT双时相联合减影技术诊断甲状旁腺功能亢进症的增益价值[J]. 国际放射医学核医学杂志，2018，42（3）：201-204. [5]华茜，巢琳，倪建明，等. SPECT/CT对甲状旁腺功能亢进症病灶术前定位扫描方案的优化[J]. 中华核医学与分子影像杂志，2018，38（5）：320-324. [6]Bagul A, Patel HP, Chadwick D, et al． Primary hyperparathyroidism: an analysis of failure of parathyroidectomy[J]. World J Surg, 2014, 38(6): 534-541． [7]魏伯俊，申虹，童冠圣，等. 99Tcm-甲氧基异丁基异腈显像在104例原发性甲状旁腺功能亢进患者诊断中的应用[J]. 中华耳鼻咽喉头颈外科杂志，2015，50（2）：123-126. [8]Ozderya A, Temizkan S, Gul AE, et al. Biochemical and pathologic factors affecting technetium-99m methoxyisobutylisonitrile imaging results in patients with primary hyperparathyroidism[J]. Ann Nucl Med, 2018, 32(4): 250-255. [9]Cordes M, Dworak O, Papadopoulos T. MIBI scintigraphy of parathyroid adenomas: correlation with biochemical and histological markers[J]. Endocr Res, 2018, 43(3): 141-148. [10]Bishop B, Wang B. Intraoperative parathormone monitoring mitigates age-related variability in targeted parathyroidectomy for patients with primary hyperparathyroidism[J]. Ann Surg Oncol, 2015, 22(10): 655-661. [11]姜涛，姚晓爱，魏伯俊，等. 性别对原发性甲状旁腺功能亢进症患者临床表现的影响[J]. 中华内科杂志，2018，57（10）：753-758. [12]Araz M, Ayir D, Erdoan M, et al. Factors affecting the sensitivity of Tc-99m methoxyisobutylisonitrile dual-phase parathyroid single photon emission computed tomography in primary hyperparathyroidism[J]. Nucl Med Commun, 2017, 38(2): 117-123. [13]Nafisi Moghadam R, Amlelshahbaz AP, Namiranian N, et al. Comparative diagnostic performance of ultrasonography and 99mTc-sestamibi scintigraphy for parathyroid adenoma in primary hyperparathyroidism: systematic review and meta-analysis[J]. Asian Pac J Cancer Prev, 2017, 18(12): 3195-3200. [14]Vitetta GM, Ravera A, Mensa G, et al. Actual role of color-Doppler high-resolution neck ultrasonography in primary hyperparathyroidism: a clinical review and an observational study with a comparison of 99mTc-sestamibi parathyroid scintigraphy[J]. J Ultrasound, 2018, 24(12): 4024-4032.