THE APPLICATION OF NUCLEAR MEDICAL TECHNOLOGY IN PRIMARY HYPERPARATHYROIDISM / 中国医师进修杂志

ABSTRACT

Objective To expound emphatically the application of nuclear medical examination in primary hyperparathyroidism.Methods 22 patients (19 adenomas,3 hyperplasia) with primary hyperparathyroidism confirmed by clinical examination and surgery underwent the detection of parathormone (PTH) by immunoradiometric assay (IRMA) and double phase 99 Tcm-MIBI parathyroid imaging,of whom 15 performed 99 TcmO-4 thyroid imaging and 8 99 Tcm-MDP bone imaging.Results The level of serum PTH in all patients (428.21±256.48) was significantly higher as compared to normal value and in cases with adenomas (781.83±194.56) was markedly elevated.The sensitivity of 99 Tcm-MIBI early and delayed phase imaging in detecting lesions of parathyroid adenomas was 84.2% and 100%,respectively.The sensitivity in detecting lesions of hyperplasia was only 33.3%.With 99 Tcm-O-4 thryoid imaging,the cold nodules were present in 2 and normality in 13.As to bone imaging,the scans were abnormal in 7.Their severities on bone scintigraph were correlated with the duration of the disease.Conclusions The level of serum PTH detected by IRMA and double phase 99 Tcm-MIBI parathyroid imaging are both sensitive methods in qualitative diagnosis and localization of hyperthyroidism.99Tcm-MIBI imaging has limited value for detecting the hyperplasia.The thyroid and bone imaging may well improve the diagnostic sensitivity and accuracy,and reflect the stage and progress of hyperparathyroidism.