Friedman Michael, Gurpinar Berk, Schalch Paul, Joseph Ninos J
Department of Otolaryngology and Bronchoesophagology, Rush University Medical Center, Chicago, IL 60602, USA.
Arch Otolaryngol Head Neck Surg. 2007 Dec;133(12):1235-9. doi: 10.1001/archotol.133.12.1235.
To confirm or refute the notion that only parathyroid adenomas have radioactivity higher than 20% of background.
Retrospective analysis of a prospective patient data set.
Tertiary care referral center.
Forty-six patients (9 men and 37 women; mean +/- SD age, 53.7 +/- 12.1 years) underwent thyroid and parathyroid surgery between December 2005 and December 2006 to collect data on ex vivo radioactivity percentages on a variety of tissues.
Patients were injected with 296 to 925 MBq of technetium Tc 99m sestamibi 1(1/2) to 3(1/2) hours before surgery. Biopsy specimens were taken of normal parathyroid glands, normal thyroid tissue, and lymph nodes and ex vivo radioactivity was recorded. Hyperplastic parathyroid glands and adenomatous glands were excised. Finally, some enlarged glands were cut into segments, and radioactivity counts were recorded and compared with the weight of the tissue.
All counts were compared with radioactivity percentages in the surrounding tissues, and results were expressed as a function of these background radioactive counts.
The mean +/- SD ex vivo background radioactivity of parathyroid adenomas was 148.5% +/- 83.1% of background activity (range, 40.1%-388.9% but never less than 40%). The mean +/- SD ex vivo background radioactivity of hyperplastic parathyroid glands was 74.6% +/- 18.0% (range, 49.5%-109.1% but never less than 40%). A significant difference was found in ex vivo background radioactivity between pathologic parathyroid tissue and the other tissue specimens studied (normal parathyroid glands [2.4% +/- 1.8%], thyroid tissue [4.5% +/- 2.8%], lymph nodes [1.6% +/- 0.8%], and fat [0.4% +/- 0.3%]).
Ex vivo radioactivity percentages can differentiate hyperactive parathyroid tissue from any other tissue, but they cannot differentiate adenoma from hyperplasia and thus are not helpful in ruling out multiglandular disease. Interpretation of ex vivo radioactivity percentages should take into consideration the size of the specimen.
证实或反驳仅甲状旁腺腺瘤的放射性高于本底20%这一观点。
对前瞻性患者数据集进行回顾性分析。
三级医疗转诊中心。
2005年12月至2006年12月期间，46例患者（9例男性和37例女性；平均±标准差年龄为53.7±12.1岁）接受了甲状腺和甲状旁腺手术，以收集各种组织的体外放射性百分比数据。
患者在手术前1（1/2）至3（1/2）小时注射296至925MBq的锝Tc 99m甲氧基异丁基异腈。获取正常甲状旁腺、正常甲状腺组织和淋巴结的活检标本，并记录体外放射性。切除增生性甲状旁腺和腺瘤样腺体。最后，将一些增大的腺体切成片段，记录放射性计数并与组织重量进行比较。
将所有计数与周围组织的放射性百分比进行比较，结果表示为这些本底放射性计数的函数。
甲状旁腺腺瘤的平均±标准差体外本底放射性为背景活性的148.5%±83.1%（范围为40.1% - 388.9%，但从不低于40%）。增生性甲状旁腺的平均±标准差体外本底放射性为74.6%±18.0%（范围为49.5% - 109.1%，但从不低于40%）。在病理性甲状旁腺组织与其他研究的组织标本（正常甲状旁腺[2.4%±1.8%]、甲状腺组织[4.5%±2.8%]、淋巴结[1.6%±0.8%]和脂肪[0.4%±0.3%]）之间发现了体外本底放射性的显著差异。
体外放射性百分比可将功能亢进的甲状旁腺组织与其他任何组织区分开来，但无法区分腺瘤与增生，因此无助于排除多腺体疾病。体外放射性百分比的解读应考虑标本大小。
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