LOCALIZATION OF PRIMARY HYPERPARATHYROIDISM WITH ~(99m)Tc-MIBI / 中华内分泌代谢杂志

ABSTRACT

Parathyroid scanning was performed with 99mTc-MIBI in 10 patients who had clinical and biochemical findings suggesting primary hyperparathyroidism but had no enlarged parathyroid or palpable thyroid. Seven cases were scanned with both 99mTc-MIBI and 99mTc and three cases with 99mTc-MIBI only but perchlorate was administered during the scan. A series of images were acquired for all cases at different time intervals after 99mTc-MIBI was injected intravenously to allow the dynamic studies. The P/T ratios (counts in parathyroid counts in thyroid)were also designed to see whether the agent had different uptakes and metabolic characteristics in parathyroid and thyroid tissues from 99mTc-MIBI. Surgical finding and histological examination were taken as gold standard against which US. CT and scintigraphy were judged. Finally, 10 adenomas found exactly at the sites predicted by scintigraphy and 2 hyperplastic glands were removed from the 10 patients. Ten of 10 99mTc-MIBI scans, two of 9 US scans and three of 8 CT scans were positive for a parathyroid adenoma, but 2 hyperplastic glands were missed by all of the three methods. It was shown that the suitable time for imaging was at 1h-2h or 30min-1h(if perchlorate was used) after 99mTc-MIBI was given, so as to render both adenoma and background clear. Despite the limited number of cases, the preliminary experience thus suggests that 99mTc-MIBI scintigraphy maybecome the technique of choice for the localization of hyperparathyroidism in stead of 21Tl.