Moka D, Voth E, Larena-Avellaneda A, Schicha H
Klinik und Poliklinik für Nuklearmedizin, Universität zu Köln.
Nuklearmedizin. 1997 Oct;36(7):240-4.
It was the of this study to assess the value of the 99mTc-MIBI scintigraphy in SPECT technique in the preoperative lateral location of small parathyroid adenoma (PTA).
25 consecutive patients (8 male, 17 female, mean age 63 +/- 13 years) with the established diagnosis of primary hyperparathyroidism and non-diagnostic ultrasonography were scanned preoperatively. After a thyroid examination to exclude radionuclide accumulating thyroid adenoma, planar and tomographic images were acquired 20 min. and 120 min. after i.v. injection of 740 MBq 99mTc-MIBI using a 3 head gamma camera (Picker Prism 3000). The first 10 patients underwent an additional 201Tl/99mTc subtraction scintigraphy in a 2 days protocol.
All patients had small, solitary PTA (< 1 g). 201Tl/99mTc subtraction scintigraphy (n = 10) showed only a sensitivity of 50%. Using planar MIBI-scintigraphy lateral location of PTA was possible in 18 cases (sensitivity: 72%). There was an increase in sensitivity up to 96% using the SPECT technique and the 3D display (volume-rendered reprojection).
In contrast to 201Tl/99mTc subtraction scintigraphy, which showed only a low sensitivity, a reliable lateral location of small PTA was obtained using the tomographic 99mTc-MIBI scintigraphy. This method offers e.g. the possibility for the surgeon to perform an unilateral parathyroidectomy.
本研究旨在评估99mTc-MIBI单光子发射计算机断层扫描（SPECT）技术在术前定位小甲状旁腺腺瘤（PTA）中的价值。
对25例确诊为原发性甲状旁腺功能亢进且超声检查未明确诊断的连续患者进行术前扫描（8例男性，17例女性，平均年龄63±13岁）。在进行甲状腺检查以排除放射性核素积聚的甲状腺腺瘤后，通过三头γ相机（Picker Prism 3000）在静脉注射740 MBq 99mTc-MIBI后20分钟和120分钟采集平面和断层图像。前10例患者按照两天方案额外进行了201Tl/99mTc减影闪烁扫描。
所有患者均患有小的孤立性PTA（<1 g）。201Tl/99mTc减影闪烁扫描（n = 10）显示敏感性仅为50%。使用平面MIBI闪烁扫描，18例患者的PTA得以进行外侧定位（敏感性：72%）。使用SPECT技术和三维显示（容积再现重投影）时，敏感性提高至96%。
与敏感性较低的201Tl/99mTc减影闪烁扫描不同，断层99mTc-MIBI闪烁扫描能够可靠地对小PTA进行外侧定位。该方法例如为外科医生进行单侧甲状旁腺切除术提供了可能。
