De Feo M L, Colagrande S, Biagini C, Tonarelli A, Bisi G, Vaggelli L, Borrelli D, Cicchi P, Tonelli F, Amorosi A, Serio M, Brandi M L
Endocrine Unit of the Department of Clinical Physiopathology, University of Florence, Italy.
Radiology. 2000 Feb;214(2):393-402. doi: 10.1148/radiology.214.2.r00fe04393.
To determine the appropriate choice of imaging techniques for localization of nodular lesions of parathyroid glands.
First, computed tomographic (CT), magnetic resonance (MR), ultrasonographic (US), and technetium 99m methoxyisobutyl-isonitrile (MIBI) scintigraphic images in 49 patients with primary hyperparathyroidism were retrospectively evaluated. A single-blind, prospective study that included 16 patients with primary hyperparathyroidism was then conducted. MR, US, scintigraphic, and color Doppler US images of the neck were obtained and analyzed.
In the retrospective study, CT, MR imaging, and US had low sensitivity (13%, 17%, and 27%, respectively) and specificity (39%, 65%, and 65%, respectively). Scintigraphy had 57% sensitivity and 85% specificity. In the prospective study, the use of latest-generation MR and US equipment and the participation of experienced operators led to improved sensitivity and specificity for these techniques. The combination of US and scintigraphy resulted in improved sensitivity (96%), specificity (83%), and positive and negative predictive values (88% and 94%, respectively), relative to the results obtained with either method alone. Doppler US was of little help in the setting of small glands.
The combination of (99m)Tc MIBI scintigraphy and US performed by well-trained operators with up-to-date instruments appeared to be the best diagnostic tool for the preoperative diagnosis of parathyroid disease.
确定用于甲状旁腺结节性病变定位的合适成像技术选择。
首先，回顾性评估49例原发性甲状旁腺功能亢进患者的计算机断层扫描（CT）、磁共振（MR）、超声（US）和锝99m甲氧基异丁基异腈（MIBI）闪烁显像图像。然后进行了一项单盲前瞻性研究，纳入16例原发性甲状旁腺功能亢进患者。获取并分析颈部的MR、US、闪烁显像和彩色多普勒US图像。
在回顾性研究中，CT、MR成像和US的敏感性较低（分别为13%、17%和27%），特异性也较低（分别为39%、65%和65%）。闪烁显像的敏感性为57%，特异性为85%。在前瞻性研究中，使用最新一代的MR和US设备以及经验丰富的操作人员参与，提高了这些技术的敏感性和特异性。与单独使用任何一种方法的结果相比，US和闪烁显像相结合提高了敏感性（96%）、特异性（83%）以及阳性和阴性预测值（分别为88%和94%）。多普勒US对小腺体的诊断帮助不大。
由训练有素的操作人员使用最新仪器进行的（99m）Tc MIBI闪烁显像和US相结合，似乎是甲状旁腺疾病术前诊断的最佳诊断工具。
