期刊文献+

碳-11胆碱PET/CT显像在原发性甲状旁腺功能亢进疑难病例术前定位诊断中的应用研究

Value of 11C-choline positron emission tomography/computed tomography in preoperative localization diagnosis of difficult cases of primary hyperparathyroidism
分享 导出
摘要 目的:探讨碳-11胆碱(11C-choline)PET/CT对原发性甲状旁腺功能亢进(primary hyperparathyroidism,PHPT)疑难病例术前定位诊断价值。方法:临床诊断PHPT拟采取手术治疗的患者92例[男21例,(54.2±14.1)岁],B超及99mTc-MIBI显像后定位困难。静脉注射111-333MBq(3-9mCi)11C-choline,20min后行PET/CT显像,采用视觉及定量方法分析图像,以病理为金标准,与血清学检查结果对照,采用IBMSPSS23进行统计分析。结果:92例患者11C-choline PET/CT显像共检出病灶103个,分别为甲状旁腺腺瘤或增生(83个)、甲状旁腺癌或其转移灶(5个)、肺神经内分泌瘤(4个)、结节性甲状腺肿(7个)和甲状腺髓样癌转移灶(4个),其中强阳性86个,弱阳性17个;未检出病灶2个,分别为甲状旁腺瘤囊性变和甲状旁腺组织,总体诊断灵敏度、特异性、准确性、阳性预测值和阴性预测值分别为98.9%、6.3%、84.8%、85.4%、50.0%。78个PHPT强阳性病灶平均最大标准摄取值(standard uptake value,SUVmax)及与甲状腺SUV比值(SUV ratio,SUVR)均明显高于10个PHPT弱阳性病灶[3.95(2.77,7.73)vs.2.60(1.95,4.42),P=0.036;1.72(1.43,2.42)vs.1.19(1.11,1.51),P=0.002]。PHPT与非PHPT组显像结果与血PTH(P=0.115)、血钙(P=0.217)、血磷(P=0.901)无关。结论:11C-cholinePET/CT显像可用于原发性甲状旁腺旁腺亢进术前定位诊断,灵敏度高,但特异性差,需注意与结节性甲状腺肿及恶性肿瘤鉴别。 Objective:To investigate the value of 11 C-choline positron emission tomography/computed tomography(PET/CT)in the preoperative localization diagnosis of difficult cases of primary hyperparathyroidism(PHPT). Methods:A total of 92 patients with PHPT(including 21 male patients aged 54.2±14.1 years)who planned to undergo surgical treatment and had difficulties in localization after ultrasound and 99m Tc -MIBI were enrolled. PET/CT was performed at 20 minutes after the intravenous injection of 111-333MBq(3-9mCi) 11 C-choline. Visual and quantitative methods were used for image analysis,and with pathological results as the gold standard,PET/CT findings were compared with the results of serological examination. IBM SPSS 23 was used for statistical analysis. Results:A total of 103 lesions were detected by 11 C-choline PET/CT in 92 patients,among which there were 83 lesions of parathyroid adenoma or hyperplasia,5 lesions of parathyroid carcinoma or its metastatic lesions,4 lesions of pulmonary neuroendocrine tumor,7 lesions of nodular goiter,and 4 lesions of metastatic lesions of medullary thyroid carcinoma;86 lesions were strongly positive and 17 were weakly positive. One lesion of cystic degeneration of parathyroidoma and one of parathyroid tissue were not detected. 11 C-choline PET/CT had an overall sensitivity of 98.9%,a specificity of 6.3%,an accuracy of 84.8%,a positive predictive value of 85.4%,and a negative predictive value of 50%. The 78 strongly positive lesions of PHPT had significantly higher maximum standard uptake value(SUV max )and standardized uptake value (SUV)ratio than the 10 weakly positive lesions(SUV max :3.95(2.77,7.73)vs. 2.60(1.95,4.42),P=0.036;SUV ratio:1.72(1.43,2.42) vs. 1.19(1.11,1.51),P=0.002). There were no significant differences between the PHPT group and the non-PHPT group in blood PTH, serum calcium,and serum phosphate(P=0.115,0.217,and 0.901). Conclusion: 11 C-choline PET/CT can be used for preoperative localization diagnosis of PHPT,with a high sensitivity and a poor specificity. The
作者 刘轶敏 党永红 霍力 胡亚 王鸥 刘赫 常晓燕 刘宇 吕京桥 邢小平 李方 廖泉 Liu Yimin;Dang Yonghong;Huo Li;Hu Ya;Wang Ou;Liu He;Chang Xiaoyan;Liu Yu;LüJingqiao;Xing Xiaoping;Li Fang;Liao Quan(Department of Nuclear Medicine,Beijing Key Laboratory of Molecular Targeted Diagnosis and Therapy in Nuclear Medicine,Peking Union Medical College(PUMC)Hospital,Chinese Academy of Medical Science &PUMC;Surgery Department,Peking Union Medical College(PUMC)Hospital,Chinese Academy of Medical Science &PUMC;Ultrasound Department,Peking Union Medical College(PUMC)Hospital,Chinese Academy of Medical Science &PUMC;Pathology Department,Peking Union Medical College(PUMC)Hospital,Chinese Academy of Medical Science &PUMC;Endocrine Department,Peking Union Medical College(PUMC)Hospital,Chinese Academy of Medical Science &PUMC)
出处 《重庆医科大学学报》 CSCD 北大核心 2018年第12期1647-1651,共5页 Journal of Chongqing Medical University
基金 国家自然科学基金资助项目(编号:81571713) 首都特色发展基金转化医学资助项目(编号:2016-2-40115) 中国医学科学院医学与健康科技创新工程重大协同创新资助项目(编号:2016-I2M-4-003,2017-12M-1-001)及北京协和医院创新团队资助项目(编号:2016).
关键词 原发性甲状旁腺功能亢进 碳-11胆碱 正电子发射断层显像/CT primary hyperparathyroidism 11 C-choline positron emission tomography/computed tomography
作者简介 刘轶敏,Email:liuyim999@163.com 研究方向:甲状旁腺功能亢进症的核医学定位诊断;通信作者:霍力,Email:huoli@pumch.cn。
  • 相关文献

参考文献1

二级参考文献1

  • 1刘彤华.甲状旁腺[A].董郡 主编.病理学:第2版[C].北京:人民卫生出版社,1998.768-772. 被引量:1

共引文献32

相关作者

内容加载中请稍等...

相关机构

内容加载中请稍等...

相关主题

内容加载中请稍等...

浏览历史

内容加载中请稍等...
;
使用帮助 返回顶部 意见反馈