Gotway M B, Reddy G P, Webb W R, Morita E T, Clark O H, Higgins C B
Thoracic Imaging Section, Department of Radiology, University of California, San Francisco General Hospital, 1001 Potrero Ave, Rm 1X 55A, Box 1325, San Francisco, CA 94110, USA.
Radiology. 2001 Mar;218(3):783-90. doi: 10.1148/radiology.218.3.r01fe38783.
To compare the sensitivity and positive predictive value of magnetic resonance (MR) imaging and technetium 99m 2-methoxyisobutyl-isonitrile (MIBI) scintigraphy for the detection of hyperfunctioning parathyroid tissue when used alone and in combination in a large patient population with recurrent or persistent hyperparathyroidism (HPT).
In 98 consecutive patients with biochemically proved recurrent or persistent HPT after surgery, MR imaging and 99mTc MIBI study findings were retrospectively reviewed and compared with surgical and histopathologic findings. The sensitivity and positive predictive value of MR imaging and 99mTc MIBI scintigraphy were compared with each other and in combination.
In these patients, 130 abnormal parathyroid glands were identified at surgery. The sensitivity and positive predictive value of MR imaging were 82% (95% CI: 75%, 89%) and 89%, respectively; those for (99m)Tc MIBI scintigraphy were 85% (95% CI: 79%, 91%) and 89%. No significant difference was found between MR imaging and 99mTc MIBI scintigraphy for sensitivity (P =.7). The sensitivity and positive predictive value for the detection of abnormal parathyroid tissue on a per-gland basis increased to 94% (95% CI: 90%, 98%) and 98%, respectively, when only one of the two tests was required to be positive.
MR imaging and 99mTc MIBI scintigraphy have similarly good sensitivity and positive predictive value for the detection of hyperfunctioning parathyroid tissue in patients after surgery. The combination of the two tests provided a substantial increase in sensitivity and positive predictive value.
比较磁共振成像（MR）和锝99m甲氧基异丁基异腈（MIBI）闪烁扫描单独及联合应用时，在大量复发性或持续性甲状旁腺功能亢进症（HPT）患者中检测功能亢进甲状旁腺组织的敏感性和阳性预测值。
对98例术后经生化证实为复发性或持续性HPT的连续患者，回顾性分析MR成像和99mTc MIBI检查结果，并与手术及组织病理学结果进行比较。比较MR成像和99mTc MIBI闪烁扫描单独及联合应用时的敏感性和阳性预测值。
在这些患者中，手术时共发现130个异常甲状旁腺。MR成像的敏感性和阳性预测值分别为82%（95%可信区间：75%，89%）和89%；99mTc MIBI闪烁扫描的敏感性和阳性预测值分别为85%（95%可信区间：79%，91%）和89%。MR成像和99mTc MIBI闪烁扫描在敏感性方面无显著差异（P = 0.7）。当两项检查中只需一项为阳性时，按每个腺体检测异常甲状旁腺组织的敏感性和阳性预测值分别增至94%（95%可信区间：90%，98%）和98%。
MR成像和99mTc MIBI闪烁扫描在检测术后患者功能亢进甲状旁腺组织方面具有相似的良好敏感性和阳性预测值。两项检查联合应用可显著提高敏感性和阳性预测值。
