Application value of 99m Tc-MIBI SPECT-CT imaging combined with ultrasound in diagnosis and treatment of secondary hyperparathyroidism

Abstract

Objective To study the application value of 99mTc-MIBI SPECT-CT imaging combined with ultrasound in diagnosis and treatment of secondary hyperparathyroidism. Methods The clinical data of 86 patients with chronic kidney disease (CKD-5) (average age of 54, average dialysis age of 7.2 years) underwent total parathyroidectomy(tPTX)and forearm autotransplantation(AT) were retrospectively analyzed. The relationship between preoperative ultrasound and SPECT parathyroid positioning seen with intraoperative and postoperative pathologic results were analyzed. Results Postoperative patients all had perfect healing, there was no unexpected complications like bleeding, infection or hoarse. A total of 198 parathyroids were positioned by preoperative ultrasond, and 181 parathyroids were positioned by SPECT, 343 parathyroids were removed by surgery. Postoperative pathological results showed parathyroid hyperplasia in 224 cases, parathyroid adenoma in 119 cases, 3 cases merged with thyroid cancer, and were removed by surgery at the same period.99mTc-MIBI SPECT/CT parathyroid imaging sensitivity was 45.3% to 86.3%, and there was significant difference in the parathyroid imaging on the up and down pole of thyroid(P<0.05). There were significant differences in the imaging sensitivity of 99mTc-MIBI SPECT/CT for parathyroid between greater than 1 cm parathyroid and less than 1 cm parathyroid. Conclusions The positioning of conventional ultrasonography and SPECT-CT examination before surgery is feasible method. SPECT/CT is important preoperative parathyroid positioning method for secondary hyperparathyroidism hysterectomy with forearm autograft, the former focuses on the significance of parathyroid adenoma andadenomatoid hyperplasia, the latter focuses on the intraoperative parathyroid search positioning, the two methods is of clinical significance for tPTX. Key words: Chronic kidney disease; Secondary hyperparathyroidism; Parathyroidectomy