纳米碳负显像结合<sup>99m</sup>Tc-MIBI术中定位甲状旁腺的研究

陈隽; 郑雯洁; 周秦毅; 冯嘉麟; 王家东

doi:10.13201/j.issn.1001-1781.2016.18.009

纳米碳负显像结合^99mTc-MIBI术中定位甲状旁腺的研究

- 上海交通大学医学院附属仁济医院头颈外科(上海, 200011)
基金项目:
仁济医院种子基金(No:RJZZ15-024)

详细信息

通讯作者: 王家东,E-mail:drjiadongw@aliyun.com

中图分类号: R582

收稿日期: 2016-05-11

Research for intraoperative localization of parathyroid gland using nanocarbon imaging combined with ^99mTc-MIBI

- Department of Head and Neck Surgery, the Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, 200011, China

More Information

Corresponding author: WANG Jiadong, E-mail: drjiadongw@aliyun.com

Received Date: 11 May 2016

摘要

摘要: 目的:探索甲状旁腺功能亢进手术中运用纳米碳混悬液和低剂量^99mTc-MIBI定位旁腺的临床应用。方法:将44例继发性肾性甲状旁腺功能亢进患者随机分为3组,即低剂量^99mTc-MIBI+纳米碳(组Ⅰ)、高剂量^99mTc-MIBI+纳米碳(组Ⅱ)、对照组(组Ⅲ)。比较其术前术后甲状旁腺激素(PTH)、血钙、术中甲状旁腺同位素放射量等实验数据。采用t检验和方差分析进行统计学处理。结果:术后PTH组Ⅰ为(23.8±32.4)ng/L,组Ⅱ为(15.8±18.2)ng/L,组Ⅲ为(90.1±139.4)ng/L,组Ⅰ与组Ⅱ均明显小于组Ⅲ,差异有统计学意义(P<0.05),组Ⅰ与组Ⅱ之间差异无统计学意义(P>0.05)。3组术中甲状旁腺的体内、体外放射量对比无明显差异。结论:纳米碳+^99mTc-MIBI对继发性甲状旁腺手术有重要的定位价值,而低剂量的^99mTc-MIBI可以减低患者的费用、降低辐射,同时可以达到相同的应用结果。
- 99mTc-MIBI /
- 甲状旁腺功能亢进 /
- 甲状旁腺定位 /
- 低剂量 /
- 纳米碳
Abstract: Objective:To explore the clinical application of nanocarbon(NC) suspension liquid combined with low dose of ^99mTc-MIBI for parathyroid localization in the hyperparathyroidism surgery.Method:Forty-four patients with secondary hyperparathyroidism(SHPT) in the department of head-neck surgery of Renji Hospital, affiliated to Shanghai Jiaotong University, School of Medicine, were enrolled and randomized into 3 groups including low-dose ^99mTc-MIBI + NC group Ⅰ, high-dose ^99mTc-MIBI + NC group Ⅱ, and control group Ⅲ. We compared the level of PTH, serum calcium before and after operation, and the intraoperative amount of radioactive isotopes of parathyroid gland, etc.Use t-test and Anova for statistical processing.Result:After operation, the PTH levels in group Ⅰ, Ⅱ, Ⅲ were(23.8±32.4)ng/L,(15.8±18.2)ng/L, (90.1±139.4)ng/L,respectively(group Ⅰ vs Ⅲ, P<0.05; group Ⅱ vs Ⅲ, P<0.05, group Ⅰ vs Ⅱ,P>0.05).The intraoperative amount of radioactive isotopes of parathyroid gland had no significant difference among group Ⅰ,group Ⅱ and group Ⅲ.Conclusion:Nanocarbon combined with ^99mTc-MIBI for SHPT surgery has important localization value. And low dose of ^99mTc-MIBI can reduce the cost and radiation, which can achieve the same outcome for patients.
- 99mTc-MIBI /
- hyperparathyroidism /
- localization /
- low dose /
- nanocarbon

HTML全文

参考文献(13)

[1]	SLATOPOLSKY E,BOWN A,DUSSO A.Role of phosphorus in pathogenesis of secondary hyperparathyroidism[J].Am J Kidney Dis,2001,37:S54-S57.
[2]	孙鲁英,王梅,终末期肾脏病患者钙磷代谢及甲状旁腺激素水平的临床分析[J].北京大学学报,2005,37(2):147-150.
[3]	AGHA A.Recurrence of secondary hyperparathyroidism in patients after total parathyroidectomy with autotransplantation:technical and therapeutic aspects[J].Eur Arch Otorhinolaryngol,2012,269:1519-1525.
[4]	MURPHY C,NORMAN J.The 20%rule:a simple,instantaneous radioactivity measurement defines cure and allows elimination of frozen sections and hormone assays during parathyroidectomy[J].Surgery,1999,126:1023-1028.
[5]	GOLDSTEIN R E,BILLHEIMER D,MARTIN W H,et al.Sestamibi scanning and minimally invasive radioguidedparathyroidectomy without intraoperative parathyroid hormone measurement[J].Ann Surg,2003,237:722-730.
[6]	RUBELLO D,GIANNINI S,MARTINI C,et al.Minimally invasive radio-guided parathyroidectomy[J].Biomed Pharmacother,2006,60:134-138.
[7]	CAYO A,CHEN H.Radioguided reoperative parathyroidectomy for persistent primary hyperparathyroidism[J].Clin Nucl Med,2008,33:668-670.
[8]	FUJII T,YAJIMA R,YAMAGUCHI S,et al.Could the eZ-SCOPE AN gamma camera replace intraoperative measurement of iPTH for PHPT[J]?Int Surg,2012,97:99-103.
[9]	FERRETTI A,CHONDROGIANNIS S,MARCOLONGO A,et al.Phantom study of a new hand-heldγ-imaging probe for radio-guided surgery[J].Nucl Med Commun,2013,34:86-90.
[10]	CHEN J,ZHOU Q Y,WANG J D.Comparison between subtotal parathyroidectomy and total parathyroidectomy with autotransplantation for secondary hyperparathyroidism in patients with chronic renal failure:a meta-analysis[J].Horm Metab Res,2015,47:643-651.
[11]	GENCOGLU E A,AKTAS A.The efficacy of low and high dose(99m)Tc-MIBI protocols for intraoperative identification of hyperplastic parathyroid glands in secondary hyperparathyroidism[J].Rev Esp Med Nucl Imagen Mol,2014,33:210-214.
[12]	CHEN J,WANG J D.Radioguidedparathyroidectomy in patients with secondary hyperparathyroidism due to chronic renal failure[J].Nucl Med Commun,2014,35:391-397.
[13]	陈隽,王家东.甲状旁腺及其周围组织在99mTc-MIBI引导的甲状旁腺切除术中放射性差异的研究[J].中华耳鼻咽喉头颈外科杂志,2012,47(9):739-742.