Primary hyperparathyroidism: higher success rate of first surgery after preoperative Tc-99m sestamibi-I-123 subtraction scanning.
Primary hyperparathyroidism: higher success rate of first surgery after preoperative Tc-99m sestamibi-I-123 subtraction scanning.
复制标题
原发性甲状旁腺功能亢进症：术前Tc-99m sestamibi-I-123减影扫描后首次手术成功率较高。
DOI：
10.1148/radiology.204.1.9205251
复制
发表时间：
1997
期刊：
影响因子：
19.7
通讯作者：
P. Gallé
中科院分区：
文献类型：
--
作者：
E. Hindié;D. Méllière;L. Perlemuter;C. Jeanguillaume;P. Gallé
目的
评价甲状旁腺疾病患者术前常规99 mTc-碘-123碘-司他米松减影扫描的有效性和成本效益。
材料和方法
对65例原发性甲状旁腺功能亢进患者进行了首次手术前评价的Tc-99 mSestamibi-I-123减影扫描。
结果
在两名接受初次胸骨切开术的患者中，在纵隔中检测到局灶性示踪剂摄取;在每种情况下，切除了升主动脉前的甲状旁腺腺瘤。在第三例患者中，成像显示甲状腺上方的示踪剂摄取;该患者接受了位于右颈动脉鞘内的未降甲状旁腺腺瘤切除术。所有患者的初次手术均治愈。术前减影扫描显示56/59例（95%）孤立性腺瘤。4例患者有增生; 2例有双腺瘤。影像学检查结果表明，在这些患者中的5个多发性甲状旁腺受累，15个（80%）肿大的腺体中有12个（80%）易于定位。检测到4个腺瘤和2个增生腺体，重量小于100 mg。任何可疑部位的阳性预测值为96%。平均手术时间从120分钟缩短到90分钟。
结论
术前减影扫描是有用的规划甲状旁腺手术，似乎是成本效益。
PURPOSE
To evaluate the usefulness and cost-effectiveness of routine preoperative technetium-99m sestamibi-iodine-123 subtraction scanning in patients with parathyroid gland disease.
MATERIALS AND METHODS
Tc-99m sestamibi-I-123 subtraction scanning was performed in 65 patients with primary hyperparathyroidism who were referred for evaluation before first surgery.
RESULTS
Focal tracer uptake was detected in the mediastinum in two patients who then underwent primary sternotomy; a parathyroid adenoma, anterior to the ascending aorta, was resected in each case. In a third patient, imaging showed tracer uptake above the thyroid gland; this patient underwent resection of an undescended parathyroid adenoma located in the sheath of the right carotid artery. Initial surgery was curative in all patients. Preoperative subtraction scans depicted 56 of 59 (95%) solitary adenomas. Four patients had hyperplasia; two had double adenoma. Imaging findings indicated multiple parathyroid involvement in five of these patients and facilitated location of 12 of 15 (80%) enlarged glands. Four adenomas and two hyperplastic glands that weighed less than 100 mg were detected. The positive predictive value for any suspected location was 96%. Average surgery time was reduced from 120 to 90 minutes.
CONCLUSION
Preoperative subtraction scanning is useful in planning parathyroid surgery and appears to be cost-effective.