定量99mTc-MIBI SPECT/CT显像参数在原发性甲状旁腺功能亢进症中的诊断价值OA

Objective:To investigate the diagnostic value of quantitative 99mTc-MIBI SPECT/CT imaging parameters in primary hyperparathyroidism(PHPT)and analyze related influencing factors.Methods:Clinical data from 48 patients with sus-pected PHPT were prospectively collected at Hebei General Hospital from February 2023 to February 2025.All patients underwent dual-phase quantitative 99mTc-MIBI SPECT/CT fusion imaging,with postoperative pathology as the gold standard.Maximum standardized uptake values(SUVmax)of lesions and normal thyroid tissue were measured using Q-metrix software.Target-to-background ratio(TBR),washout(W),and retention index(RI)were calculated based on SUVmax.ROC curve analy-sis was performed to evaluate diagnostic efficacy,and Spearman rank correlation analysis was used to test the correlations between quantitative parameters and parathyroid hormone(PTH),calcium,and phosphorus levels.Results:A total of 68 lesions were surgically removed(44 parathyroid lesions,24 thyroid lesions).The parathyroid lesion group showed significantly higher early SUVmax(median 8.98 vs.3.66),delayed SUVmax(median 4.96 vs.2.06),delayed TBR(1.37 vs.0.60),and RI(1.29 vs.0.98)compared to the thyroid lesion group(P<0.01).The areas under the curve(AUC)for delayed SUVmax,delayed TBR,and RI were 0.727,0.722,and 0.759,respectively,with a combined model AUC of 0.800.PTH showed weak to moderate positive correlations with early SUVmax,delayed SUVmax and TBR(|rs|=0.372～0.516,P<0.05).Conclusion:SUVmax and its derived parameters from 99mTc-MIBI SPECT/CT imaging can effectively differentiate parathyroid from thyroid lesions,improv-ing the accuracy of preoperative localization in PHPT.Some parameters correlate with PTH and calcium levels,suggesting their potential to reflect the functional status of lesions.