| Hyperparathyroidism divided into primary,secondary and tertiary hyperparathyroidismo Hyperparathyroidism is a relatively common endocrine diseases,it can be divided into primary and secondary two categories according to the cause,the primary is common(holds 80 percent and above)。The primary hyperparathyroidism is caused by parathyroid disease itself,with parathyroid hormone(parathyroid hormone,PTH)excessivly synthesizing and secreting,and involving multiple body organs。The main symptoms are recurrent kidney stones,peptic ulcer,and the change of spirit and extensive bone damage,those who is serious can generate bone fractures。PTH can stimulate the bone modeling,resulting in hypercalcemia,hypophosphatemia and blood alkaline phosphatase increased。Secondary hyperparathyroidism, which is cause by kidney disease or other diseases,causes low blood calcium or high phosphorus,consequently stimulates glandulae parathyroideae and produce secondary hyperparathyroidism。There are three sources of parathyroid lesions。Adenoma holds about more than 80 percent;and about 10%of the cases are parathyroid hyperplasia;hyperparathyroidism which casue by parathyroid carcinoma is a relatively rare,less than 2 percent。Glandulae parathyroideae is a small organ,it widely resides in the spread between neck and superior mediastinum。It is difficult to cure hyperparathyroidism by surgery,especially for the patients with multiple adenomas,adenomas ectopic and have commited surgery which lead to structural change,it can often leads to the failure of surgery。Therefore, preoperative localization of the lesions before surgery is extremely important。This study selected 44 hyperparathyroidism cases who did 99mTc-MIBI parathyroid imaging before operation since 2005 to 2007 in our Section。They did parathyroid imaging for further diagnosis。And all the patients did parathyroid transonogram(n=44)and CT(n=21)at the same time for the relative property studies。20 cases with thyreocele or thyroid adenoma did 99mTc-MIBI parathyroid imaging,compared with 44 case with pHPT。To approach the ascendancy of 99mTc-MIBI dual-phase imaging in the diagnosis of a hyperparathyroidism,and provide useful information and basis for localization of the parathyroid before clinical operation。99mTc-MIBI dual-phase imaging is a functional imaging methods which can only develope hyperfunction epithelial body,the results are relatively objective,and use the vision parallel hole collimators to detect,can also prevent the missed diagnosis of ectopic parathyroid lesions;for the simply method,clearer images,the better sensitivity and accuracy compare with transonogram and CT,with practical and forward-looking,it is a noninvasive screening method utend in clinical for positioning of epithelial body with high function before operation。This research data show that:the detection rate of adenoid tumor by transonogram,CT and 99mTc-MIBI dual-phase imaging respectively is 97.3%,67.6%,62.5%。The detection rate of 99mTc-MIBI dual-phase imaging is obviously higher than the detection rate of transonogram and CT(P＜0.05)。The saitivity of 99mTc-MIBI dual-phase imaging is 90.91%,specificity is95%,accuracy rating is 92.19%;the saitivity of transonogram is 63.64%,specificity is 85%,accuracy rating is 70.31%;the saitivity of CT is 57.14%,specificity is 90%,accuracy rating is73.17%。In the aspect of saitivity and accuracy rating,the 99mTc-MIBI dual-phase imaging group is obviously higher than transonogram and CT group(P＜0.05)。Therefore,99mTc-MIBI dual-phase imaging of hyperactive epithelial body for preoperative localization of the parathyroid have important clinical value, and is an important means of preventing misdiagnosis。Especially utendus ectopic parathyroid adenoma localization。... |
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