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tuyen can giapABSTRACT:
CLINICAL APPLICATION OF SCINTIGRAPHY FOR HYPERPARATHYROIDISM DETECTION

Background: Hyperparathyroidism occurs with a frequency of 0,5‰ with half of the patients being asymptomatic and detected by serum calcium screening. Because of the small size and location of normal parathyroid glands, imaging with most modalities is difficult. Hyperfunctioning glands, however, can be imaged by using nuclear medicine techniques, but there are two basic premises: All patients should have their disease already diagnosed by biochemical and clinical evaluation, and the imaging procedure should be used to anatomic localize or classify the process (hyperplasia vs. adenoma).

This test composes less than 2% of all nuclear medicine procedures but parathyroid scintigraphy is especially useful in patients with negative neck explorations and recurrent or persistent hypercalcemia, some avocated the use of single-photon emission computed tomography (SPECT) imaging to increase the sensitivity of 99mTc-sestamibi examinations for parathyroid lesions. Purpose Confirmation of 99mTc-sestamibi imaging role in diagnosis of hyperparathyroidism. Subjects and methods: Prospective cross-sectional study was performed in 28 patients transferred to NM department of Cho Ray hospital due to clinical suggestion of hyperparathyroidism during 2 years 2010-2011. Results and discussion Female:Male ratio is 23:5 (female counts for 82,14%), mean age is about 49,06±16,24. 15 patients were operated with histology of parathyroid adenomas in 6 pts, all of them had positive scans. MIBI scan with SPECT acquisition has yielded sensitivity rates of about 86%, and combination with Pertechnetate scan increases the specificity for parathyroid lesions of 100%. Conclusions: Technetium-99m Sestamibi is the radiopharmaceutical of choice for imaging hyperplasia and adenomas of parathyroid glands because of its good energy characteristic for imaging. Modified technique with reinjecting the patient with Tc-99m pertechnetate may be helpful to confirm parathyroid lesions.

Đọc toàn văn

Hội Nội Tiết- Đái Tháo Đường Miền Trung Việt Nam

Diabetes- Endocrinology- Metabolism Association of central Vietnam

Tổng biên tập: NGƯT.GS.TS. NGUYỄN HẢI THỦY

Liên hệ ban biên tập: 0903574457, email: nhthuy52@gmail.com hoặc admin@dema-cvn.com

Năm xuất bản: 12/2010