99m锝甲氧基异丁基异腈双期甲状旁腺单光子发射计算机断层扫描图像得出的半定量参数与原发性甲状旁腺功能亢进症疾病严重程度之间的关系。

The relationship between semiquantitative parameters derived from technetium-99m metoxyisobutylisonitrile dual-phase parathyroid single-photon emission computed tomography images and disease severity in primary hyperparathyroidism.

作者信息

Çayir Derya, Araz Mine, Yalçindağ Ali, Çakal Erman

机构信息

Departments of Nuclear Medicine.

Biochemistry.

出版信息

Nucl Med Commun. 2018 Apr;39(4):304-311. doi: 10.1097/MNM.0000000000000803.

DOI:10.1097/MNM.0000000000000803

PMID:29360693

Abstract

OBJECTIVE

The relationship between multiple semiquantitative indices on technetium-99m metoxyisobutylisonitrile (Tc-99m MIBI) parathyroid single-photon emission computed tomography (SPECT) and clinical, laboratory, and radiological data was investigated in primary hyperparathyroidism.

PATIENTS AND METHODS

Ninety-three patients who had a histopathologically confirmed single parathyroid adenoma (PT) were enrolled. Regions of interests were drawn around the PT, neighboring thyroid (T), and background in early and late planar images and isocontour regions of interests around the adenoma in SPECT images (PT SPECT). The relationships between early and late PT, parathyroid adenoma counts/neighboring thyroid counts, parathyroid counts-thyroid counts (PT-T), PT washout, retention index, PT SPECT and serum parathormone (PTH), Ca, P, urinary Ca levels, weight of the adenoma, neck ultrasonography, renal ultrasonography, and bone mineral density findings were investigated.

RESULTS

There was a positive correlation between the weight of the adenoma and serum PTH and calcium (Ca) levels (P<0.001), between serum PTH and Ca levels (P<0.001), early PT-T and serum Ca levels (P=0.027), late PT-T and weight of the adenoma (P=0.04), and PT SPECT and serum Ca levels (P=0.046) and a reverse correlation between PT SPECT and serum phosphorus (P) levels (P=0.04). Serum Ca levels were significantly higher and P levels were lower in the group with PT SPECT values above 116. PT SPECT and late parathyroid adenoma counts/neighboring thyroid counts values were significantly higher in the group with serum Ca levels of more than 11 mg/dl. Femoral T and Z scores were significantly lower in patients with lower PT washout. Early PT was significantly lower in patients with coexisting thyroiditis compared with patients with both thyroiditis and thyroid nodules (P=0.034).

CONCLUSION

Semiquantitative evaluation of a Tc-99m MIBI parathyroid SPECT study may help predict disease severity in primary hyperparathyroidism.

摘要

目的

研究原发性甲状旁腺功能亢进症中锝-99m甲氧基异丁基异腈（Tc-99m MIBI）甲状旁腺单光子发射计算机断层扫描（SPECT）上多个半定量指标与临床、实验室及放射学数据之间的关系。

患者与方法

纳入93例经组织病理学证实为单发甲状旁腺腺瘤（PT）的患者。在早期和晚期平面图像上，围绕PT、邻近甲状腺（T）及背景绘制感兴趣区，并在SPECT图像（PT SPECT）上围绕腺瘤绘制等轮廓感兴趣区。研究早期和晚期PT、甲状旁腺腺瘤计数/邻近甲状腺计数、甲状旁腺计数-甲状腺计数（PT-T）、PT洗脱率、滞留指数、PT SPECT与血清甲状旁腺激素（PTH）、钙（Ca）、磷（P）、尿钙水平、腺瘤重量、颈部超声、肾脏超声及骨密度检查结果之间的关系。

结果

腺瘤重量与血清PTH及钙（Ca）水平之间存在正相关（P<0.001），血清PTH与Ca水平之间存在正相关（P<0.001），早期PT-T与血清Ca水平之间存在正相关（P=0.027），晚期PT-T与腺瘤重量之间存在正相关（P=0.04），PT SPECT与血清Ca水平之间存在正相关（P=0.046），PT SPECT与血清磷（P）水平之间存在负相关（P=0.04）。PT SPECT值高于116的组中，血清Ca水平显著升高而P水平降低。血清Ca水平高于11mg/dl的组中，PT SPECT及晚期甲状旁腺腺瘤计数/邻近甲状腺计数的值显著更高。PT洗脱率较低的患者中，股骨T值和Z值显著更低。与合并甲状腺炎和甲状腺结节的患者相比，合并甲状腺炎的患者早期PT显著更低（P=0.034）。