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Paratiroid adenomunda Tc-99m MIBI retansiyonu ile intakt parathormon düzeyleri arasındaki ilişki

The relationship between Tc-99m MIBI retention and intact parathyroid hormone levels in parathyroid adenoma

Journal Name:

  • Gülhane Tıp Dergisi

Publication Year:

  • 2007

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Abstract (2. Language): 
Tc-99m MIBI parathyroid scintigraphy and intact parathyroid hormone (iPTH) assay are important diagnostic tests for hyperparathyroidism. The aim of the current study was to assess the relationship between Tc-99m MIBI retention and iPTH levels in parathyroid adenoma. Thirty patients (21 female, 9 male, aged 52.47 years, range 27 to 80) who had findings on parathyroid scintigraphy compatible with parathyroid adenoma and were confirmed to have the same diagnosis after surgery were included in the study. Anterior neck imaging was performed at the 10th and 120th minutes after the intravenous administration of Tc-99m MIBI. Regions of interest were generated from the tissues of parathyroid adenoma and normal thyroid tissue, and the early (E) and late (L) parathyroid/thyroid ratios were calculated. Retention index was calculated using the formula of (LE)X100/E. The iPTH levels of the patients were between 9 to 1705 pmol/L (median: 30.5 pmol/L). The retention indexes ranged between 4 to 158 (median: 14.5). There was a significant correlation between the retention index and iPTH level (p=0.0001). As a conclusion scintigraphic visualization of parathyroid adenomas in patients with high levels of serum iPTH is better. In cases with low iPTH levels, detection of the adenoma is difficult due to decreased MIBI retention.
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Abstract (Original Language): 
Hiperparatiroidizmde Tc-99m MIBI paratiroid sintigrafisi ve intakt parathormon (iPTH) düzeyi ölçümü, önemli tanısal yöntemlerdir. Bu çalışmanın amacı paratiroid adenomunda Tc-99m MIBI retansiyonu ile iPTH düzeyleri arasındaki ilişkiyi değerlendirmektir. Tc-99m MIBI paratiroid sintigrafisinde paratiroid adenomu ile uyumlu bulgu saptanan ve operasyon ile sonucu doğrulanan 30 hasta (21 kadın, 9 erkek; ortalama yaş: 52.47 yıl, yaş aralığı: 27-80) çalışmaya dahil edildi. Tc-99m MIBI'nin intravenöz enjeksiyonundan sonra 10. ve 120. dakikalarda anteriyor boyun görüntülemesi yapıldı. Paratiroid adenomu ve normal tiroid dokusundan ilgi alanları çizildikten sonra erken (E) ve geç (G) paratiroid/tiroid oranları hesaplandı. Retansiyon indeksi hesaplamasında (G-E)X100/E formülü kullanıldı. Hastaların iPTH düzeyleri 9- 1705 pmol/L arasında (ortanca değeri: 30.5 pmol/L) idi. Retansiyon indeksi değerleri 4-158 arasında değişmekte olup, ortanca değeri 14.5 olarak hesaplandı. Retansiyon indeksi ile iPTH düzeyi arasında istatistiksel olarak anlamlı ilişki saptandı (p=0.0001). Sonuç olarak serum iPTH düzeyi yüksek olan olguların paratiroid adenomlarının sintigrafik görüntülenmesinin daha iyi olduğu görülmektedir. iPTH düzeyinin düşük olduğu durumda MIBI retansiyonunun azalmasına bağlı olarak adenomun saptanabilirliği güçleşmektedir.
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  • Turkish

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