Localization in primary hyperparathyroidism

doi:10.1016/j.beem.2024.101967

2024-12-01

PRE

DOI：10.1016/j.beem.2024.101967

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原发性甲状旁腺功能亢进是高钙血症的主要原因，主要继发于甲状旁腺腺瘤，其次为增生。诊断依赖于临床和生化参数。准确的术前定位对于更好的手术效果至关重要。各种无创影像学方法包括颈部超声、99mTc-甲氧基异丁基异腈（99mTc-Methoxyisobutyl isonitrile）放射性核素闪烁扫描联合SPECT/CT、4DCT、MRI以及18F-胆碱PET/CT。功能影像在病灶定位方面显示出更高的准确性，尤其是在异位甲状旁腺腺瘤和持续性或复发性甲状旁腺功能亢进中。联合超声和99mTc-MIBI比单一影像方法显示出更高的敏感性和特异性。18F-胆碱PET/CT在识别甲状旁腺增生和多发腺瘤方面具有更好的诊断性能。对于检查结果不明确且合并甲状腺结节性疾病的患者，18F-胆碱PET/MRI和4DCT有助于更好地表征病灶。术中探针引导手术有助于实现靶向和微创手术，从而获得更好的手术效果。需要开发更特异性的放射性药物用于甲状旁腺成像，以减少假阳性结果。

Keyword:

hyperparathyroidism

primary

adenoma

hyperplasia

positron emission tomography/ computed

tomography

minimally invasive surgical procedures

hypercalcemia

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Best Practice and Research Clinical Endocrinology and Metabolism

IF:

6.1

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1.7K

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5.5K

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