Department of Oncology and Nuclear Medicine, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia.
Acta Clin Croat. 2022 Feb;60(3):423-428. doi: 10.20471/acc.2021.60.03.12.
Parathyroid scintigraphy with Tc-MIBI is an imaging technique used in nuclear medicine and performed in patients with suspected hyperparathyroidism (HPT). The objective of this study was to evaluate the role of this technique in patients who, along with suspected HPT, also have thyroid nodules. Retrospective analysis included a period of 8 years (2006-2013). The study included 91 patients with clinical or laboratory suspected HPT. Pathologic changes in parathyroid glands were demonstrated in 47 (70%) of 67 patients with positive scintigraphy. Pathologic changes in parathyroid glands were not evident in the remaining 20 (30%) patients. Out of nine patients with negative scintigraphy results but with suspected enlargement of the parathyroid gland examined by ultrasound, eight (89%) patients did not show pathologic changes in the parathyroid gland, whereas one (11%) patient had evident changes. Eight (54%) of 15 patients with suspected scintigraphy had positive ultrasound findings, as well as fine needle aspiration cytology (FNAC) findings with parathyroid hormone (PTH) determination in the aspirate. Seven (46%) patients had negative FNAC findings and PTH in the aspirate. The study showed scintigraphy to have high sensitivity (98%) in detecting patients with pathologic changes in the parathyroid glands. In patients with suspected HPT, scintigraphy needs to be combined with FNAC and PTH determination in the aspirate due to its low specificity of 28%.
甲状旁腺闪烁显像术是核医学中常用的一种成像技术，用于疑似甲状旁腺功能亢进症（HPT）的患者。本研究的目的是评估该技术在同时伴有疑似 HPT 和甲状腺结节的患者中的作用。回顾性分析包括 8 年时间（2006-2013 年）。研究纳入了 91 例有临床或实验室疑似 HPT 的患者。在 67 例阳性闪烁显像患者中，有 47 例（70%）显示甲状旁腺有病理变化。在其余 20 例（30%）患者中，甲状旁腺无明显病理变化。在 9 例阴性闪烁显像结果但超声检查疑似甲状旁腺肿大的患者中，8 例（89%）患者的甲状旁腺无病理变化，1 例（11%）患者有明显变化。在 15 例疑似闪烁显像的患者中，有 8 例（54%）患者的超声检查和细针抽吸细胞学（FNAC）检查结果以及抽吸物中甲状旁腺激素（PTH）测定均为阳性。7 例（46%）患者的 FNAC 检查和抽吸物中的 PTH 为阴性。研究表明，该技术检测甲状旁腺有病理变化的患者具有很高的灵敏度（98%）。在疑似 HPT 的患者中，由于其特异性仅为 28%，因此需要将闪烁显像与 FNAC 和抽吸物中的 PTH 测定相结合。
