原发性甲状旁腺功能亢进症手术中的术中微型γ相机
The intraoperative mini gamma camera in primary hyperparathyroidism surgery.
作者信息
Estrems Paloma, Guallart Fernando, Abreu Pedro, Sopena Pablo, Dalmau José, Sopena Ramón
机构信息
Servicio de Otorrinolaringología, Hospital Universitario Doctor Peset, Valencia, España.
出版信息
Acta Otorrinolaringol Esp. 2012 Nov-Dec;63(6):450-7. doi: 10.1016/j.otorri.2012.04.009. Epub 2012 Oct 26.
INTRODUCTION AND OBJECTIVES
The evolution of primary hyperparathyroidism surgical treatment has been improved by the arrival of new techniques that allow for better parathyroid gland tracking. A mini gamma camera has recently been developed that makes it possible to take intraoperative parathyroid gammagraphies. The objective of this study was to evaluate the utility of this technique.
METHOD
We prospectively studied 29 patients with primary hyperparathyroidism, comparing the diagnostic effectiveness of the MGP with the results obtained with preoperative techniques (ultrasound scan plus Tc(99m)-sestamibi gammagraphy).
RESULTS
The sensitivity and specificity of the mini gamma camera was superior to those of the preoperative techniques, applied to the lateral neck as well as to the face of the neck (lateral: 89.6% sensitivity and 96.15% specificity compared to 79.31% and 92.59% respectively; and neck face: sensitivity and specificity 83.33% and 90.91% against 48.39% and 72.73%).
CONCLUSIONS
The portable mini gamma camera accurately tracks pathologic parathyroid glands. In that sense, it could be useful when considering a radio-guided surgery with minimal parathyroid invasion.
引言与目的
新技术的出现改进了原发性甲状旁腺功能亢进症的外科治疗方法，这些技术有助于更好地追踪甲状旁腺。最近研发出一种微型γ相机，能够进行术中甲状旁腺γ显像。本研究的目的是评估该技术的实用性。
方法
我们前瞻性地研究了29例原发性甲状旁腺功能亢进症患者，将微型γ相机（MGP）的诊断有效性与术前技术（超声检查加Tc(99m)-甲氧基异丁基异腈γ显像）的结果进行比较。
结果
微型γ相机的敏感性和特异性优于术前技术，无论是应用于颈部外侧还是颈部前面（外侧：敏感性89.6%，特异性96.15%，而术前技术分别为79.31%和92.59%；颈部前面：敏感性和特异性分别为83.33%和90.91%，术前技术分别为48.39%和72.73%）。
结论
便携式微型γ相机能够准确追踪病变甲状旁腺。从这个意义上讲，在考虑进行微创甲状旁腺手术时，它可能会很有用。
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