核素显像对原发性甲状旁腺功能亢进可视化诊断进展

邬心爱; 邬永军; 王雪梅

doi:10.12122/j.issn.1674-4500.2024.01.16

核素显像对原发性甲状旁腺功能亢进可视化诊断进展

doi: 10.12122/j.issn.1674-4500.2024.01.16

1.
内蒙古医科大学附属医院核医学科，内蒙古自治区分子影像学重点实验室，内蒙古呼和浩特 010000
2.
鄂尔多斯东胜区人民医院急诊科，内蒙古鄂尔多斯 017000

基金项目:

内蒙古自治区卫生健康科技计划项目 202201314

详细信息

作者简介:
邬心爱，在读博士研究生，主治医师，E-mail: 1102799005@qq.com

通讯作者:
王雪梅，博士，主任医师，E-mail: wangxuemei201010@163.com

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- 文章访问数: 103
- HTML全文浏览量: 56
- PDF下载量: 8
- 被引次数: 0
出版历程
- 收稿日期: 2023-09-15
- 网络出版日期: 2024-01-23
- 刊出日期: 2024-01-20

Progress in visualization diagnosis of primary hyperparathyroidism using nuclide imaging

WU Xin'ai^1
,,
WU Yongjun²,
WANG Xuemei^{1
, ,}

1.
Department of Nuclear Medicine, Affiliated Hospital of Inner Mongolia Medical University, Key Laboratory of Molecular Imaging of Inner Mongolia Autonomous Region, Hohhot 010000, China
2.
Department of Emergency, Ordos Dongsheng District People's Hospital, Ordos 017000, China

摘要

摘要: 原发性甲状旁腺功能亢进（PHPT）是一种常见的内分泌疾病，常伴有钙、磷代谢紊乱及多系统病变。手术切除是治疗PHPT的主要手段，随着微创手术的推广应用，术前分子影像学精准定位成为迫切需要。核素显像双时相^99mTc-MIBI SPECT/CT、¹¹C-choline及¹⁸F-Fluorocholine PET/CT一直是PHPT术前定位研究的热点，现就^99mTc-MIBI、¹¹C-choline及¹⁸F-Fluorocholine基本显像原理，三种核素显像方式在异位/复发病变、多腺体病变、PTH升高与核素显像结果不一致及既往颈部手术史的PHPT术前定位临床应用优缺点新进展相关文献进行综述。
- 原发性甲状旁腺功能亢进 /
- SPECT/CT /
- PET/CT /
- 术前定位
Abstract: Primary hyperparathyroidism (PHPT) is a common endocrine disease, often accompanied by calcium and phosphorus metabolism disorders and multi-system lesions. Surgical resection is the main method for the treatment of PHPT. With the popularization and application of minimally invasive surgery, preoperative molecular imaging has become an urgent need for accurate localization. Radionuclide imaging of dual-phase ^99mTc-MIBI SPECT/CT, ¹¹C-choline and ¹⁸F-Fluorocholine PET/CT have always been the focus of preoperative localization research for PHPT. The basic imaging principles of ^99mTc-MIBI, ¹¹C-choline and ¹⁸F-Fluorocholine are presented. The advantages and disadvantages of these radionuclide imaging methods in the clinical applications of PHPT preoperative localization in ectopic/recurrent lesions, polyglandular lesions, inconsistent between PTH elevation with radionuclide imaging findings, and previous neck surgery history were reviewed.
- primary hyperparathyroidism /
- SPECT/CT /
- PET/CT /
- preoperative localization

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参考文献(47)

[1]	Majcen M, Hocevar M. Surgical options in treating patients with primary hyperparathyroidism[J]. Radiol Oncol, 2020, 54(1): 22-32. doi: 10.2478/raon-2020-0010
[2]	Elgazzar A, Anim J, Dannoon S, et al. Ultrastructure of hyperfunctioning parathyroid glands: does it explain various patterns of ^99mTc-sestamibi uptake[J]. World J Nucl Med, 2017, 16(2): 145-9. doi: 10.4103/1450-1147.203073
[3]	张莹莹, 韩娜, 武凤玉, 等. ⁹⁹Tc m-MIBI SPECT/CT显像在原发性甲状旁腺功能亢进症术前诊断中的价值及影响因素[J]. 中华核医学与分子影像杂志, 2021, 41(6): 345-9. doi: 10.3760/cma.j.cn321828-20200408-00142
[4]	杨玲, 丁浩源, 蔡亮, 等. ^99mTc-MIBI SPECT/CT在甲状旁腺功能亢进症中的应用价值[J]. 中国临床医学影像杂志, 2021, 32(1): 5-9.
[5]	刘斌, 李玉琴, 黄蕊, 等. ^99mTc-MIBI SPECT/CT及颈部超声在原发性甲状旁腺功能亢进症术前诊断中的应用[J]. 分子影像学杂志, 2022, 45(4): 595-8. doi: 10.12122/j.issn.1674-4500.2022.04.24
[6]	刘轶敏, 陈黎波, 刘宇, 等. ^99mTc-MIBI针孔准直器双时相显像与平行孔准直器SPECT/CT断层融合显像术前定位诊断原发性甲状旁腺功能亢进症的临床价值比较[J]. 协和医学杂志, 2023, 14(4): 774-80.
[7]	Khan AA, Hanley DA, Rizzoli R, et al. Primary hyperparathyroidism: review and recommendations on evaluation, diagnosis, and management. A Canadian and international consensus[J]. Osteoporos Int, 2017, 28(1): 1-19. doi: 10.1007/s00198-016-3716-2
[8]	陈则君, 薛勤, 黄钱焕, 等. ^99mTc-MIBI SPECT/CT显像联合超声对继发性甲状旁腺功能亢进症患者甲状腺内异位甲状旁腺的术前定位[J]. 中华骨质疏松和骨矿盐疾病杂志, 2020, 13(2): 126-32. doi: 10.3969/j.issn.1674-2591.2020.02.004
[9]	章锐, 田瑶, 沈文状, 等. 原发性甲状旁腺功能亢进症63例诊治分析[J]. 临床外科杂志, 2018, 26(6): 424-6. doi: 10.3969/j.issn.1005-6483.2018.06.007
[10]	Xue JJ, Liu Y, Yang DR, et al. Dual-phase ^99mTc-MIBI imaging and the expressions of P-gp, GST-π, and MRP1 in hyperparathyroidism[J]. Nucl Med Commun, 2017, 38(10): 868-74. doi: 10.1097/MNM.0000000000000721
[11]	Bae EH, Kim HS, Kim MJ, et al. Hypercalcemia in a patient with polycythemia vera[J]. Chonnam Med J, 2012, 48(2): 128-9. doi: 10.4068/cmj.2012.48.2.128
[12]	Beheshti M, Hehenwarter L, Paymani Z, et al. ¹⁸F-Fluorocholine PET/CT in the assessment of primary hyperparathyroidism compared with ^99mTc-MIBI or ^99mTc-tetrofosmin SPECT/CT: a prospective dual-centre study in 100 patients[J]. Eur J Nucl Med Mol Imaging, 2018, 45(10): 1762-71. doi: 10.1007/s00259-018-3980-9
[13]	王雪薇, 张妍妍, 韩哲, 等. 核素扫描为假阴性原发性甲状旁腺功能亢进症手术时机及治疗策略的把握[J]. 中国普外基础与临床杂志, 2020, 27(7): 880-3.
[14]	Oliver Guillén JR, de la Cueva Barrao L, Miguelena Bobadilla JM, et al. Cystic parathyroid adenoma: primary hyperparathyroidism without ^99mTc-MIBI uptake[J]. Rev Española De Med Nucl E Imagen Mol Engl Ed, 2017, 36(4): 254-6.
[15]	赵燕霞, 于立明. ^99mTc-MIBI显像阴性甲状旁腺癌致甲状旁腺功能亢进症1例[J]. 中国临床医学影像杂志, 2020, 31(1): 67-9.
[16]	王静, 朱玉春, 蔡国强, 等. 甲状旁腺病灶重量对99Tc m-MIBI显像诊断灵敏度的影响[J]. 国际放射医学核医学杂志, 2020, 44(6): 352-8. doi: 10.3760/cma.j.cn121381-201903012-00037
[17]	周建立, 王健, 朱富强. 甲状旁腺功能亢进症患者血清PTH水平与^99mTc-MIBI SPECT/CT双时相显像的相关性研究[J]. 中国临床医学影像杂志, 2020, 31(3): 171-4.
[18]	Dugonjić S, Šišić M, Radulović M, et al. Positive ^99mTc-MIBI and the subtraction parathyroid scan are related to intact parathyroid hormone but not to total plasma calcium in primary hyperparathyroidism[J]. Hell J Nucl Med, 2017, 20(1): 46-50.
[19]	Lu M, Kjellin H, Fotouhi O, et al. Molecular profiles of oxyphilic and chief cell parathyroid adenoma[J]. Mol Cell Endocrinol, 2018, 470: 84-95. doi: 10.1016/j.mce.2017.10.001
[20]	Ferrari C, Santo G, Mammucci P, et al. Diagnostic value of choline PET in the preoperative localization of hyperfunctioning parathyroid gland(s): a comprehensive overview[J]. Biomedicines, 2021, 9(3): 231. doi: 10.3390/biomedicines9030231
[21]	邬心爱, 邬永军, 王雪梅, 等. ¹⁸F-FDG双时相及 ¹⁸F-FDG联合 ¹¹C-CHO PET/CT多模态显像在原发性肝细胞肝癌中的诊断价值[J]. 国际放射医学核医学杂志, 2021, 45(3): 139-46.
[22]	Castilla-Lièvre MA, Franco D, Gervais P, et al. Diagnostic value of combining ¹¹C-choline and ¹⁸F-FDG PET/CT in hepatocellular carcinoma[J]. Eur J Nucl Med Mol Imaging, 2016, 43(5): 852-9. doi: 10.1007/s00259-015-3241-0
[23]	Damle N, Tripathi M, Behera A, et al. Utility of ¹⁸F-choline photon emission tomography/computed tomography in the diagnosis of parathyroid adenoma[J]. Indian J Nucl Med, 2016, 31(3): 207.
[24]	段晓晔, 马婉璐, 朱庆莉, 等. 骨痛、高甲状旁腺素血症、^99mTc MIBI甲状旁腺显像阴性[J]. 中华骨质疏松和骨矿盐疾病杂志, 2019, 12(2): 172-6.
[25]	Lenschow C, Wennmann A, Hendricks A, et al. Questionable value of ^99mTc-sestamibi scintigraphy in patients with pHPT and negative ultrasound[J]. Langenbecks Arch Surg, 2022, 407(8): 3661-9.
[26]	Noltes ME, Kruijff S, Jansen L, et al. A retrospective analysis of the diagnostic performance of ¹¹C-choline PET/CT for detection of hyperfunctioning parathyroid glands after prior negative or discordant imaging in primary hyperparathyroidism[J]. EJNMMI Res, 2021, 11(1): 32.
[27]	Saha S, Vierkant RA, Johnson GB, et al. ¹¹C-choline PET/CT succeeds when conventional imaging for primary hyperparathyroidism fails[J]. Surgery, 2023, 173(1): 117-23.
[28]	Orevi M, Freedman N, Mishani E, et al. Localization of parathyroid adenoma by ¹¹C-choline PET/CT[J]. Clin Nucl Med, 2014, 39(12): 1033-8.
[29]	Liu YM, Dang YH, Huo L, et al. Preoperative localization of adenomas in primary hyperparathyroidism: the value of ¹¹C-choline PET/CT in patients with negative or discordant findings on ultrasonography and ^99mTc-sestamibi SPECT/CT[J]. J Nucl Med, 2020, 61(4): 584-9.
[30]	Parvinian A, Martin-Macintosh EL, Goenka AH, et al. ¹¹C-choline PET/CT for detection and localization of parathyroid adenomas[J]. AJR Am J Roentgenol, 2018, 210(2): 418-22.
[31]	Noltes ME, Kruijff S, Noordzij W, et al. Optimization of parathyroid ¹¹C-choline PET protocol for localization of parathyroid adenomas in patients with primary hyperparathyroidism[J]. EJNMMI Res, 2019, 9(1): 1-10.
[32]	刘轶敏, 党永红, 霍力, 等. ¹¹C-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[J]. 重庆医科大学学报, 2018, 43(12): 1647-51.
[33]	Christensen JW, Ismail A, Søndergaard SB, et al. Preoperative imaging in primary hyperparathyroidism: are ¹¹C-Choline PET/CT and ^99mTc-MIBI/123Iodide subtraction SPECT/CT interchangeable or do they supplement each other?[J]. Clin Endocrinol, 2022, 97: 258-67.
[34]	Uludag M, Unlu MT, Kostek M, et al. Persistent and recurrent primary hyperparathyroidism: etiological factors and pre-operative evaluation[J]. Sisli Etfal Hastan Tip Bul, 2023, 57(1): 1-17.
[35]	Rep S, Lezaic L, Kocjan T, et al. Optimal scan time for evaluation of parathyroid adenoma with ¹⁸F-fluorocholine PET/CT[J]. Radiol Oncol, 2015, 49(4): 327-33.
[36]	Prabhu M, Damle NA. Fluorocholine PET imaging of parathyroid disease[J]. Indian J Endocrinol Metab, 2018, 22(4): 535-41.
[37]	王洁, 庞华, 夏铸, 等. 比较¹⁸F-氟代胆碱PET/CT、^99mTc-甲氧基异丁基异腈SPECT/CT及超声诊断甲状旁腺功能亢进症[J]. 中国医学影像技术, 2022, 38(3): 358-62.
[38]	Quak E, Lasne Cardon A, Ciappuccini R, et al. Upfront ¹⁸F-choline PET/CT versus ^99mTc-sestaMIBI SPECT/CT guided surgery in primary hyperparathyroidism: the randomized phase Ⅲ diagnostic trial APACH2[J]. BMC Endocr Disord, 2021, 21(1): 3.
[39]	Fischli S, Suter-Widmer I, Nguyen BT, et al. The significance of ¹⁸F-fluorocholine-PET/CT as localizing imaging technique in patients with primary hyperparathyroidism and negative conventional imaging[J]. Front Endocrinol, 2018, 8: 380.
[40]	Uslu-Beşli L, Sonmezoglu K, Teksoz S, et al. Performance of ¹⁸F-fluorocholine PET/CT for detection of hyperfunctioning parathyroid tissue in patients with elevated parathyroid hormone levels and negative or discrepant results in conventional imaging[J]. Korean J Radiol, 2020, 21(2): 236-47.
[41]	Thanseer N, Bhadada SK, Sood A, et al. Comparative effectiveness of ultrasonography, ^99mTc-sestamibi, and ¹⁸F-fluorocholine PET/CT in detecting parathyroid adenomas in patients with primary hyperparathyroidism[J]. Clin Nucl Med, 2017, 42(12): e491-e497.
[42]	Weber T, Gottstein M, Schwenzer S, et al. Is ¹¹C-methionine PET/CT able to localise sestamibi-negative parathyroid adenomas?[J]. World J Surg, 2017, 41(4): 980-5.
[43]	Talbot JN, Zhang YJ, Kerrou K, et al. Multiple endocrine neoplasia type 1 or 4: detection of hyperfunctioning parathyroid glands with ¹⁸F-fluorocholine PET/CT. Illustrative cases and pitfalls[J]. Q J Nucl Med Mol Imaging, 2022, 66(2): 130-40.
[44]	Hocevar M, Lezaic L, Rep S, et al. Focused parathyroidectomy without intraoperative parathormone testing is safe after pre-operative localization with ¹⁸F-Fluorocholine PET/CT[J]. Eur J Surg Oncol EJSO, 2017, 43(1): 133-7.
[45]	Talbot JN, Périé S, Tassart M, et al. ¹⁸F-fluorocholine PET/CT detects parathyroid gland hyperplasia as well as adenoma: 401 PET/CTs in one center[J]. Q J Nucl Med Mol Imaging, 2023, 67(2): 96-113.
[46]	Michaud L, Burgess A, Huchet V, et al. Is ¹⁸F-fluorocholine-positron emission tomography/computerized tomography a new imaging tool for detecting hyperfunctioning parathyroid glands in primary or secondary hyperparathyroidism[J]?. J Clin Endocrinol Metab, 2014, 99(12): 4531-6.
[47]	Boudousq V, Guignard N, Gilly O, et al. Diagnostic performance of cervical ultrasound, ^99mTc-sestamibi scintigraphy, and contrast-enhanced ¹⁸F-fluorocholine PET in primary hyperparathyroidism[J]. J Nucl Med, 2022, 63(7): 1081-6.

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核素显像对原发性甲状旁腺功能亢进可视化诊断进展

doi: 10.12122/j.issn.1674-4500.2024.01.16

作者简介:
邬心爱，在读博士研究生，主治医师，E-mail: 1102799005@qq.com

通讯作者:
王雪梅，博士，主任医师，E-mail: wangxuemei201010@163.com

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Progress in visualization diagnosis of primary hyperparathyroidism using nuclide imaging

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目录

留言板

核素显像对原发性甲状旁腺功能亢进可视化诊断进展

doi: 10.12122/j.issn.1674-4500.2024.01.16

作者简介: 邬心爱，在读博士研究生，主治医师，E-mail: 1102799005@qq.com

通讯作者: 王雪梅，博士，主任医师，E-mail: wangxuemei201010@163.com

计量

出版历程

Progress in visualization diagnosis of primary hyperparathyroidism using nuclide imaging

计量

出版历程

目录

作者简介:
邬心爱，在读博士研究生，主治医师，E-mail: 1102799005@qq.com

通讯作者:
王雪梅，博士，主任医师，E-mail: wangxuemei201010@163.com