Akin Murat, Atasever Tamer, Kurukahvecioglu Osman, Dogan Mehmet, Gokaslan Devrim, Poyraz Aylar, Koksal Hande, Taneri Ferit
Gazi University Medical School, Department of General Surgery, Ankara, Turkey.
Bratisl Lek Listy. 2009;110(3):166-9.
The objective of this study was to compare the dual phase MIBI scinitgraphy with MIBI and Tc-99m pertechnetate (MIBI + Tc-99m) study in defining the parathyroid adenomas, and to evaluate the effect of histologic and biochemical characteristics on the imaging of parathyroid adenomas with Tc-99m methoxyisobutylisonitrile (MIBI) scintigraphy.
Thirty-six patients with parathyroid adenomas were studied prospectively. All patients were evaluated with both MIBI and (MIBI + Tc-99m) study. MIBI uptake of adenomas correlated with oxyphill, chief cell and tumour weight of the surgically excised glands. MIBI uptake was also compared with serum calcium (Ca), phosphorus (P) and intact parathormone (iPTH) levels.
A total of 38 parathyroid adenomas were surgically excised from 36 patients. MIBI + Tc-99m identified 35 of the parathyroid lesions (92%). Whereas, MIBI study detected 30 of the 38 parathyroid adenomas (79% sensitivity) (p=0.0001). There were no false positives. Adenoma weight showed significiant correlation with MIBI uptake (p=0.001). Oxyphyill cell content also showed high correlation with MIBI uptake. Delayed images showed better correlation than the early views (Early MIBI p=0.033; Delayed MIBI; p=0.001).
MIBI + Tc-99m pertechnetate interpretation is more sensitive than only dual MIBI imaging for the detection of parathyroid adenoma. Oxyphill cell content and weight of the lesions proved to be important determinants of 99mTc-MIBI accumulation in parathyroid adenoma. We found no significant correlation between MIBI accumulation, Ca, P and iPTH serum levels (Tab. 2, Fig. 2, Ref. 15). Full Text (Free, PDF) www.bmj.sk.
本研究的目的是比较双时相甲氧基异丁基异腈（MIBI）闪烁扫描法与MIBI和高锝酸盐（MIBI + Tc-99m）联合检查在诊断甲状旁腺腺瘤方面的效果，并评估组织学和生化特征对Tc-99m甲氧基异丁基异腈（MIBI）闪烁扫描法检测甲状旁腺腺瘤成像的影响。
对36例甲状旁腺腺瘤患者进行前瞻性研究。所有患者均接受MIBI和（MIBI + Tc-99m）联合检查。腺瘤的MIBI摄取与手术切除腺体中的嗜酸性细胞、主细胞及肿瘤重量相关。MIBI摄取还与血清钙（Ca）、磷（P）和完整甲状旁腺激素（iPTH）水平进行比较。
36例患者共手术切除38个甲状旁腺腺瘤。MIBI + Tc-99m联合检查发现了35个甲状旁腺病变（92%）。而MIBI检查在38个甲状旁腺腺瘤中检测出30个（灵敏度为79%）（p = 0.0001）。无假阳性结果。腺瘤重量与MIBI摄取呈显著相关（p = 0.001）。嗜酸性细胞含量与MIBI摄取也高度相关。延迟图像显示的相关性优于早期图像（早期MIBI，p = 0.033；延迟MIBI，p = 0.001）。
对于甲状旁腺腺瘤的检测，MIBI +高锝酸盐检查比单纯的双时相MIBI成像更敏感。病变的嗜酸性细胞含量和重量被证明是甲状旁腺腺瘤中99mTc-MIBI聚集的重要决定因素。我们发现MIBI聚集与血清Ca、P和iPTH水平之间无显著相关性（表2，图2，参考文献15）。全文（免费，PDF）www.bmj.sk 。
