원발성 부갑상선 기능 항진증의 수술 전 병소확인검사 Tc99m MIBI 주사검사와 Tl201/Tc99m 감산 주사검사의 비교
Preoperative Localization in Primary Hyperparathyroidism Comparison of Tc99m MIBI Scan and Tl201/Tc99m Subtraction Scan
강경호, 장명철, 노동영, 윤여규, 문병인, 오승근,
소속 상세정보
강경호 ( Kang Kyung-Ho )
서울대학교 의과대학 외과학교실
장명철 ( Chang Myung-Chul )
서울대학교 의과대학 외과학교실
노동영 ( Roh Dong-Young )
서울대학교 의과대학 외과학교실
윤여규 ( Youn Yeo-Kyu )
서울대학교 의과대학 외과학교실
문병인 ( Moon Byung-In )
이화여자대학교 의과대학 외과학교실
오승근 ( Oh Seung-Keun )
서울대학교 의과대학 외과학교실
KMID : 0371320020630010023
Abstract
Purpose: Recently Tc99m MIBI (methoxyisobutylisonitrile) has been described as an alternative to thallium for localizing parathyroid lesions. The purpose of this study was to compare the efficacy of a Tc99m MIBI scan
with a
Tl201/Tc99m subtraction scan for localizing parathyroid lesions in patients with primary hyperparathyroidism.
Methods: Among 31 cases of primary hyperparathyroidism operated on at the Department of Surgery, Seoul National University Hospital from January 1997 to June 2001, a Tl201/Tc99m subtraction scan was performed on 16
patients
and a Tc99m MIBI scan on 22 patients. Seven patients underwent both.
Results: The pathology was a single adenoma in 28 patients, a hyperplasia in 1 patient and a carcinoma in 2 patients. Hypercalcemia was controlled postoperatively in all cases. The sensitivities of the Tl201/Tc99m
subtraction scan and Tc99m MIBI scan were 53.3% and 86.4%, respectively. The positive predictive values were 100% of the two study groups.
Conclusion: We concluded that the better accuracy, superior image quality and lower cost of Tc99m MIBI scan will make it the new radiopharmaceutical parathyroid scan of choice. A unilateral approach can be used with a high degree
of
success, as in case of a preoperatively localized single parathyroid adenoma, which was confirmed when surgical exploration identified of a normal ipsilateral gland.
키워드
원발성 부갑상선 기능 항진증; MIBI 주사검사; Tl201/Tc99m 감산 주사검사; Primary hyperparathyroidism; MIBI Scan; Tl201/Tc99m subtraction scan;
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