Localization value of ultrasonography, contrast-enhanced ultrasound and 99mTc-MIBI SPECT/CT in refractory secondary hyperparathyroidism

doi:10.3877/cma.j.issn.1672-6448.2018.07.010

Abstract

Abstract:

Objective

To explore the diagnostic value of ultrasonography (US), contrast-enhanced ultrasonography (CEUS), (^99mTc-MIBI) single photon emission computed tomography/computed tomography (SPECT/CT) in refractory secondary hyperparathyroidism.

Methods

From August 2015 to August 2017, 18 cases of refractory hyperparathyroidism admitted to the Affiliated Hospital of Qingdao University were collected. All patients underwent US, CEUS, ^99mTc-MIBI SPECT/CT imaging before operation. The diagnostic efficiency of the three methods was compared with the pathological results as the gold standard.

Results

A total of 73 nodules were removed from 18 cases, 71 of them were parathyroid nodules confirmed by pathology. The imaging sensitivity of US, CEUS, ^99mTc-MIBI SPECT/CT was 98.59%, 94.37% and 78.87% respectively, and the accuracy was 97.26%, 94.52% and 78.08% respectively. There was no significant difference between US and CEUS in locating parathyroid hyperplasia nodules (P=0.250). The diagnostic value of US and CEUS was superior to ^99mTc-MIBI SPECT/CT (P=0.001, 0.012), and the specificity was increased when combination of US with CEUS (50.00% vs 100.00%). When combined with ^99mTc-MIBI SPECT/CT imaging, the accuracy of localization was further improved (98.63% vs 100.00%).

Conclusion

For refractory secondary hyperparathyroidism, comprehensive preoperative diagnosis can be made after combined application of US, CEUS and ^99mTc-MIBI SPECT/CT.

Key words: Ultrasonography, Technetium Tc 99m sestamibi, Tomography, spiral computed, Hyperparathyroidism

Xiumei Li, Jun Li, Hongqiao Wang, Chunping Ning, Caiyun Jiang, Maoping Zhou, Shuang Mou, Jingru Yang, Hongmei Wu. Localization value of ultrasonography, contrast-enhanced ultrasound and ^99mTc-MIBI SPECT/CT in refractory secondary hyperparathyroidism[J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2018, 15(07): 522-529.

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URL: https://chaosheng.cma-cmc.com.cn/EN/10.3877/cma.j.issn.1672-6448.2018.07.010

https://chaosheng.cma-cmc.com.cn/EN/Y2018/V15/I07/522

Figures/Tables 8

References 16

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部位	个数	部位	个数
左上	5	右上	2
左中	14	右中	16
左下	17	右下	17

部位	个数	部位	个数
左上	5	右上	2
左中	14	右中	16
左下	17	右下	17

检查结果	枚数	最大径线（cm）	平均径线（cm）	体积（mm³）
检出	56	1.57±0.50（0.80~2.70）	1.18±0.34（0.60~2.0）	944.08±830.95（70.2~3 863.1）
未检出	15	1.29±0.61（0.40~2.40）	0.99±0.40（0.30~1.50）	610.06±540.89（25.0~1 591.20）
t值	?	1.837	1.851	1.471
P值	?	0.205	0.239	0.328

检查结果	枚数	最大径线（cm）	平均径线（cm）	体积（mm³）
检出	56	1.57±0.50（0.80~2.70）	1.18±0.34（0.60~2.0）	944.08±830.95（70.2~3 863.1）
未检出	15	1.29±0.61（0.40~2.40）	0.99±0.40（0.30~1.50）	610.06±540.89（25.0~1 591.20）
t值	?	1.837	1.851	1.471
P值	?	0.205	0.239	0.328

检查方法	敏感度（%）	特异度（%）	准确性（%）
高频超声	98.59（70/71）	50.00（1/2）	97.26（71/73）
超声造影	94.37（67/71）	100.00（2/2）	94.52（69/73）
^99mTc-MIBI SPECT/CT	78.87（56/71）	50.00（1/2）	78.08（57/73）
高频超声＋超声造影	98.59（70/71）	100.00（2/2）	98.63（72/73）
超声造影＋^99mTc-MIBI SPECT/CT	95.77（68/71）	100.00（2/2）	95.89（70/73）
高频超声＋^99mTc-MIBI SPECT/CT	100.00（71/71）	50.00（1/2）	98.63（72/73）
高频超声＋超声造影＋^99mTc-MIBI SPECT/CT	100.00（71/71）	100.00（2/2）	100.00（73/73）

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