Abd Elhameed Elsayed Wafaa, Ali Rasha A
Nuclear Medicine, Sohag University Hospital, Sohag, EGY.
Epidemiology and Public Health, Sohag University Hospital, Sohag, EGY.
Cureus. 2019 Jun 20;11(6):e4960. doi: 10.7759/cureus.4960.
The aim of our study was to evaluate the efficacy of preoperative dual-phase 99mTc-methoxyisobutylnitrile (MIBI) parathyroid scintigraphy (PS), and ultrasound (US) in primary hyperparathyroidism (pHPT) diagnosis and compare the results with the surgical findings.
Forty-five patients were enrolled in this study. Preoperative serum parathyroid hormone (PTH) levels, calcium (Ca), phosphate (P), and alkaline phosphatase (AP) levels were measured. All parathyroid patients were evaluated by ultrasonography, dual phase 99mTc-MIBI. Surgical findings were used as a reference standard.
Of the 45 patients included in this study, 30 were females (66.7%) with an age range between 30 years and 70 years (mean age 41± 13). The sensitivity and specificity of 99mTc-MIBI scintigraphy was 97.4% and 71.4%, respectively, while the sensitivity of ultrasound was 94.4% and specificity 44.4%. The sensitivity, specificity, and accuracy of combined scintigraphy and ultrasound was higher-97.4%, 83.3%, and 95.6%, respectively.
The combination of MIBI and US appears promising for localizing parathyroid pathology in patients with primary hyperparathyroidism. The concordance rate is high together with a lower chance of missing concomitant thyroid pathology, which might alter the surgical approach.
本研究旨在评估术前双相99mTc-甲氧基异丁基异腈（MIBI）甲状旁腺闪烁扫描（PS）及超声（US）在原发性甲状旁腺功能亢进症（pHPT）诊断中的疗效，并将结果与手术所见进行比较。
本研究纳入45例患者。术前测定血清甲状旁腺激素（PTH）水平、钙（Ca）、磷（P）及碱性磷酸酶（AP）水平。所有甲状旁腺疾病患者均接受超声检查及双相99mTc-MIBI检查。手术所见用作参考标准。
本研究纳入的45例患者中，30例为女性（66.7%），年龄在30岁至70岁之间（平均年龄41±13岁）。99mTc-MIBI闪烁扫描的敏感性和特异性分别为97.4%和71.4%，而超声的敏感性为94.4%，特异性为44.4%。闪烁扫描与超声联合检查的敏感性、特异性和准确性更高，分别为97.4%、83.3%和95.6%。
MIBI与US联合应用在定位原发性甲状旁腺功能亢进症患者的甲状旁腺病变方面似乎很有前景。一致性率高，同时遗漏伴发甲状腺病变的可能性较低，而伴发甲状腺病变可能会改变手术方式。
