双能 CT 应该作为原发性甲状旁腺功能亢进症患者的一线术前定位影像学检查方法。
Dual energy computed tomography should be a first line preoperative localization imaging test for primary hyperparathyroidism patients.
机构信息
Department of Surgery, St. Paul's Hospital & University of British Columbia, Vancouver, BC, Canada.
Department of Radiology, St. Paul's Hospital & University of British Columbia, Vancouver, BC, Canada.
出版信息
Am J Surg. 2018 May;215(5):788-792. doi: 10.1016/j.amjsurg.2017.11.048. Epub 2018 Jan 5.
BACKGROUND
The objective of this study was to evaluate the performance of dual-energy computed tomography (DECT) for preoperative parathyroid tumor (PT) localization in primary hyperparathyroid (PHP) patients.
METHODS
A retrospective review was carried out of the medical records of all PHP patients who underwent ultrasound (US), Tc-99m sestamibi noncontrast single photon emission computed tomography (CT-MIBI), DECT and parathyroidectomy at a single center.
RESULTS
The sensitivities and accuracies for preoperative PT localization in the 97 patient study population were: US 40% and 93%, CT-MIBI 64.0% and 97%, and DECT 84% and 96%, respectively. In the one third of the study population that did not localize preoperatively with CT-MIBI and US, DECT correctly localized a PT in 21 cases (66%). DE-CT and US correctly localized a PT in 86% of cases, and only 5 (8%) of the cases that were accurately localized by a combination of CT-MIBI and US were not identified by DE-CT.
CONCLUSIONS
DECT should be utilized as a first line preoperative PT localization study in PHP patients, and is also a sensitive salvage localization test.
背景
本研究旨在评估双能 CT（DECT）在原发性甲状旁腺功能亢进症（PHP）患者甲状旁腺瘤（PT）术前定位中的性能。
方法
对在一家中心接受超声（US）、Tc-99m sestamibi 非对比单光子发射 CT（CT-MIBI）、DECT 和甲状旁腺切除术的所有 PHP 患者的病历进行了回顾性分析。
结果
97 例患者研究人群的术前 PT 定位的敏感度和准确率分别为：US 为 40%和 93%，CT-MIBI 为 64.0%和 97%，DECT 为 84%和 96%。在三分之一未通过 CT-MIBI 和 US 进行术前定位的患者中，DECT 正确定位了 21 例（66%）PT。DE-CT 和 US 正确定位了 86%的病例，而仅 5 例（8%）通过 CT-MIBI 和 US 准确定位的病例未被 DE-CT 识别。
结论
DECT 应作为 PHP 患者术前 PT 定位的首选研究方法，也是一种敏感的挽救性定位试验。
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