双能计算机断层扫描：一种用于原发性甲状旁腺功能亢进症治疗的有前景的新型术前定位研究。
Dual-energy computed tomography: a promising novel preoperative localization study for treatment of primary hyperparathyroidism.
作者信息
Seyednejad Nazgol, Healy Ciaran, Tiwari Pari, Vos Patrick, Sexsmith George, Melck Adrienne, Hague Cameron, Wiseman Sam M
机构信息
Department of Surgery, St. Paul's Hospital & University of British Columbia, 1081 Burrard Street, Vancouver, British Columbia, V6Z 1Y6, Canada.
Department of Radiology, St. Paul's Hospital & University of British Columbia, Vancouver, British Columbia, Canada.
出版信息
Am J Surg. 2016 May;211(5):839-45. doi: 10.1016/j.amjsurg.2016.01.003. Epub 2016 Feb 26.
BACKGROUND
The objective of this study was to evaluate dual-energy computed tomography (DE-CT) for preoperative parathyroid tumor (PT) localization in individuals undergoing parathyroidectomy for treatment of primary hyperparathyroidism (PHP).
METHODS
DE-CT was evaluated by retrospective review of the clinical and biochemical characteristics, imaging, operative findings, and outcomes for PHP cases undergoing an initial operation at a single center.
RESULTS
The accuracy of each preoperative imaging test, based on operative findings and pathological confirmation of removal of a PT from the localized site was: 58% for ultrasound, 75% Tc-99m sestamibi noncontrast single photon emission noncontrast CT, and 75% for DE-CT. DE-CT was able to correctly localize a PT in a 3rd of cases that were nonlocalized. All study patients had normalization of serum calcium and parathyroid hormone levels postoperatively.
CONCLUSIONS
DE-CT shows promise for the preoperative PT localization, especially in nonlocalized PHP cases, and warrants further investigation.
背景
本研究的目的是评估双能计算机断层扫描（DE-CT）在接受甲状旁腺切除术治疗原发性甲状旁腺功能亢进症（PHP）的患者术前甲状旁腺肿瘤（PT）定位中的应用。
方法
通过回顾性分析在单一中心接受初次手术的PHP病例的临床和生化特征、影像学检查、手术结果及预后，对DE-CT进行评估。
结果
基于手术结果及从定位部位切除PT的病理证实，每种术前影像学检查的准确性分别为：超声58%，锝-99m甲氧基异丁基异腈非增强单光子发射非增强CT 75%，DE-CT 75%。DE-CT能够在三分之一的未定位病例中正确定位PT。所有研究患者术后血清钙和甲状旁腺激素水平均恢复正常。
结论
DE-CT在术前PT定位方面显示出前景，尤其是在未定位的PHP病例中，值得进一步研究。
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