Wilkinson R H, Leight G S, Garner S C, Borges-Neto S
Department of Radiology, Duke University Medical Center, Durham, North Carolina 27710, USA.
Clin Nucl Med. 2000 Mar;25(3):173-8. doi: 10.1097/00003072-200003000-00002.
This article illustrates the complementary nature of preoperative radionuclide parathyroid imaging and intraoperative rapid parathyroid hormone (PTH) assays in primary hyperparathyroid disease. The authors review the literature on these procedures and compare this protocol and its cost-effectiveness with those of the classic four-gland exploration.
Preoperative parathyroid imaging with Tc-99m MIBI and intraoperative rapid PTH assays were performed at the time of neck exploration.
One of two parathyroid adenomas seen on radionuclide images would have been missed if the authors had relied solely on the initial decrease in PTH assay value to a normal level.
Tc-99m MIBI imaging and intraoperative rapid PTH assays are complementary; when used together, they lessen the likelihood that abnormal parathyroid glands will be overlooked. This experience and that of others suggest these combined procedures are cost-effective.
本文阐述了术前放射性核素甲状旁腺显像与术中快速甲状旁腺激素（PTH）检测在原发性甲状旁腺疾病中的互补性。作者回顾了关于这些检查方法的文献，并将该方案及其成本效益与经典的四腺探查术进行了比较。
在颈部探查时进行术前锝-99m甲氧基异丁基异腈（Tc-99m MIBI）甲状旁腺显像及术中快速PTH检测。
如果作者仅依赖PTH检测值最初降至正常水平，那么放射性核素图像上显示的两个甲状旁腺腺瘤中的一个将会被漏诊。
Tc-99m MIBI显像与术中快速PTH检测具有互补性；联合使用时，它们可降低甲状旁腺异常被漏诊的可能性。本文作者及其他研究者的经验表明，这些联合检查方法具有成本效益。
