锝-99m甲氧基异丁基异腈扫描引导下的微创电视辅助甲状旁腺切除术：治疗孤立性甲状旁腺腺瘤的有效方法。
Sestamibi scan-directed, minimally invasive video-assisted parathyroidectomy: an effective treatment for solitary parathyroid adenoma.
作者信息
Murphy A D, Andrews E J, Ishtiaq A, Jawad A, McCarthy P A, O'Keeffe D, Dunne F, Quill D S
机构信息
Department of Surgery, University College Hospital, Galway, Ireland.
出版信息
Ir J Med Sci. 2007 Dec;176(4):283-7. doi: 10.1007/s11845-007-0075-1. Epub 2007 Aug 28.
BACKGROUND
Solitary adenomas have been shown to be responsible for almost 90% of cases of primary hyperparathyroidism.
AIM
The purpose of this study was to determine the utility of sestamibi scanning pre-operatively to guide minimally invasive video-assisted (MIVA) parathyroidectomy.
METHODS
We reviewed 40 patients who underwent parathyroidectomy between 2003 and 2004. All patients underwent a pre-operative sestamibi scan.
RESULTS
Thirty-three (82%) patients had a localized solitary adenoma on sestamibi scan. Of these patients 29 underwent attempted MIVA parathyroidectomy. MIVA parathyroidectomy was successful in 22 patients. When pre-operative sestamibi scanning was correlated with pathological diagnosis it was shown to have a sensitivity of 82% and positive predictive value of 94%.
CONCLUSION
Pre-operative sestamibi scan localization of a parathyroid adenoma offers a 94% positive predictive value for adenoma location. This facilitates MIVA parathyroidectomy to be used effectively to treat primary hyperparathyroidism in the majority of patients.
背景
孤立性腺瘤已被证明是导致几乎90%原发性甲状旁腺功能亢进病例的原因。
目的
本研究的目的是确定术前进行甲氧基异丁基异腈扫描对指导微创电视辅助（MIVA）甲状旁腺切除术的作用。
方法
我们回顾了2003年至2004年间接受甲状旁腺切除术的40例患者。所有患者均接受了术前甲氧基异丁基异腈扫描。
结果
33例（82%）患者在甲氧基异丁基异腈扫描中发现有局限性孤立性腺瘤。其中29例患者尝试进行MIVA甲状旁腺切除术。22例患者的MIVA甲状旁腺切除术成功。当术前甲氧基异丁基异腈扫描与病理诊断相关联时，显示其敏感性为82%，阳性预测值为94%。
结论
甲状旁腺腺瘤的术前甲氧基异丁基异腈扫描定位对腺瘤定位的阳性预测值为94%。这有助于MIVA甲状旁腺切除术有效地用于治疗大多数患者的原发性甲状旁腺功能亢进。
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