Duarte Paulo Schiavon, Decker Helena H, Aldighieri Flávia C, Brandão Cynthia, Alonso Gilberto, Vieira José Gilberto H
Centro de Medicina Diagnóstica, Instituto Fleury, São Paulo, SP.
Arq Bras Endocrinol Metabol. 2005 Dec;49(6):930-7. doi: 10.1590/s0004-27302005000600012. Epub 2006 Mar 16.
To correlate PTH and calcium serum levels with the percentages of positive results on the parathyroid scintigraphy, we retrospectively analyzed 194 patients who performed parathyroid scintigraphy. The distribution of the parathyroid scintigraphy results was visually analyzed in a scatter plot, being calcium (Y axis) and PTH (X axis) serum levels the axes. Six groups of patients were defined: 1) calcium > or = 12 mg/dL; 2) 11 mg/dL calcium < 12 mg/dL; 3) 9.9 mg/dL < or = calcium < 11 mg/dL with PTH > 120 pg/mL; 4) 9.9 mg/dL < or = calcium < 11 mg/dL with 65 pg/mL < PTH < or = 120 pg/mL; 5) 9.9 mg/dL < or = calcium < 11 mg/dL with PTH < or = 65 pg/mL; and 6) calcium < 9.9 mg/dL. The percentage of positive scintigraphy in these groups were respectively: 10/10 (100%), 18/29 (62%), 7/9 (78%), 18/45 (40%), 2/21 (10%) and 1/80 (1%). We conclude that in patients with suspected primary hyperparathyroidism, parathyroid scintigraphies performed before surgery on those with calcium level above 11 mg/dL are frequently positive. In patients with calcium levels between 9.9 mg/dL and 11 mg/dL the pertinence of performing the scintigraphy will depend on the PTH levels, and it will be high for patients with PTH serum level above 120 pg/mL and very low for patients with PTH level below 65 pg/mL. Patients with calcium level below 9.9 mg/dL rarely present positive results on parathyroid scintigraphies.
为了将甲状旁腺激素（PTH）和血清钙水平与甲状旁腺闪烁扫描阳性结果的百分比相关联，我们回顾性分析了194例行甲状旁腺闪烁扫描的患者。在散点图中直观分析甲状旁腺闪烁扫描结果的分布情况，以血清钙水平（Y轴）和PTH水平（X轴）为坐标轴。定义了六组患者：1）钙≥12mg/dL；2）11mg/dL＜钙＜12mg/dL；3）9.9mg/dL≤钙＜11mg/dL且PTH＞120pg/mL；4）9.9mg/dL≤钙＜11mg/dL且65pg/mL＜PTH≤120pg/mL；5）9.9mg/dL≤钙＜11mg/dL且PTH≤65pg/mL；6）钙＜9.9mg/dL。这些组中闪烁扫描阳性的百分比分别为：10/10（100%）、18/29（62%）、7/9（78%）、18/45（40%）、2/21（10%）和1/80（1%）。我们得出结论，在疑似原发性甲状旁腺功能亢进的患者中，术前对钙水平高于11mg/dL的患者进行甲状旁腺闪烁扫描，结果常为阳性。对于钙水平在9.9mg/dL至11mg/dL之间的患者，是否进行闪烁扫描取决于PTH水平，PTH血清水平高于120pg/mL的患者相关性高，而PTH水平低于65pg/mL的患者相关性很低。钙水平低于9.9mg/dL的患者甲状旁腺闪烁扫描很少出现阳性结果。
