Author |
신중우(Jung Woo Shin),류진숙(Jin Sook Ryu),김재승(Jae Seung Kim),문대혁(Dae Hyuk Moon),홍승모(Seung Mo Hong),공경엽(Gyungyub Gong),홍석준(Suk Joon Hong),이희경(Hee Kyung Lee), |
Abstract |
Purpose: This study was performed to evaluate the
diagnostic usefulness of double-phase Tc-99m MIBI
parathyroidism scintigraphy with single photon emission
computed tomography (SPECT) in patients with
hyperparathyroidism. We also evaluated the relationship
between Tc-99m MIBI uptake and oxyphil cell contents in
parathyroid glands. Materials and Methods: The subjects
were 28 parathyroid glands of 10 patients who underwent
Tc-99m MIBI parathyroid scintigraphy and
parathyroidectomy for clinically suspected
hyperparathyroidism. Early and delayed pinhole images
were obtained at 15 minutes and 2 hours after injection
of Tc-99m MIBI, and SPECT images were followed. The
weight and oxyphil cell contents of parathyroid of
tissue were obtained from pathologic specimen, and the
scintigraphic findings were compared with
histopathology. Results: In surgical histopathology, 6
parathyroid adenomas and 9 parathyroid hyperplasias
were confirmed. The sensitivity, specificity, and
positive predictive value of early and delayed images
were 46.7% (7/15), 76.9% (10/13), 70% (7/10) and 667%
(10/15), 92.3% (12/13), 90.9% (10/11), respectively.
SPECT image detected an additional small hyperplasia.
The sensitivity, specificity, and positive predictive
value of combined interpretation of early and delayed
images with SPECT were 733% f11/15), 100% (13/13), 100%
(11/11). The sensitivity was 100% (6/6) for aenoma,
whereas that was 555% (5/9) for hyperplasia. Both
adenomas and hyperplasias showed significantly
increased oxyphil cell contents compared with normal
parathyroid glands (p<0.0001), but the oxyphil cell
content and weight were not significantly different
between adenomas and hyperplasias. Conclusion: Double-
phase Tc-99m MIBI parathyroid scintigraphy with SPECT
is useful for lesion localization m patients with
hyperparathyroidism. Although both adenoma and
hyperplasia have increased oxyphil cell content, the
sensitivity is high in adenoma, but low in hyperplasia. |