Moolenaar W, Heslinga J M, Arndt J W, vd Velde C J, Pauwels E K, Valentijn R M
Department of Nephrology and Internal Medicine, University Hospital, Leiden, The Netherlands.
Nephrol Dial Transplant. 1988;3(2):166-8.
In a group of 14 patients with chronic renal failure and secondary hyperparathyroidism, subtraction scintigraphy with 201Tl and 99mTc for parathyroid localisation was performed prior to subtotal parathyroidectomy. Fourteen of 38 (37%) enlarged hyperplastic glands found at first operation corresponded with the hot spots seen on the preoperative scans. Four of five (80%) found at a second operation had also been detected this way preoperatively. Postoperative scans were performed in nine patients. All hot foci seen on the preoperative scans had disappeared. In two patients new hot spots emerged correlating with known residual parathyroid tissue, and also in one patient with recurrent secondary hyperparathyroidism. We conclude that this diagnostic method is of limited value prior to the first neck exploration in secondary hyperparathyroidism of chronic renal failure. However it might be a useful method in the evaluation of patients with signs of persistent or recurrent hyperparathyroidism.
在一组14例慢性肾衰竭合并继发性甲状旁腺功能亢进的患者中，在次全甲状旁腺切除术前进行了201Tl和99mTc减影闪烁扫描以定位甲状旁腺。首次手术时发现的38个（37%）增大的增生性腺体中有14个与术前扫描所见的热点相对应。第二次手术时发现的5个（80%）中有4个术前也通过这种方式检测到。9例患者进行了术后扫描。术前扫描所见的所有热点均消失。2例患者出现了与已知残留甲状旁腺组织相关的新热点，1例继发性甲状旁腺功能亢进复发的患者也出现了新热点。我们得出结论，这种诊断方法在慢性肾衰竭继发性甲状旁腺功能亢进的首次颈部探查之前价值有限。然而，它可能是评估有持续性或复发性甲状旁腺功能亢进体征患者的一种有用方法。
