目的:评估四维计算机断层扫描(4DCT)定位甲状旁腺腺瘤(PTAs)的准确性,在不一致或非定位超声(US)和Tech-99Sestamibi(MIBI)扫描的情况下。
方法:回顾性病例系列和系统评价。
方法:对被诊断为原发性甲状旁腺功能亢进且US和MIBI扫描不一致的患者进行病例系列和荟萃分析,这些患者在手术前接受了4DCT。对2006年12月至2022年3月期间英语文献中的所有相关出版物进行了全面搜索,以进行荟萃分析。在2015年1月至2021年12月期间接受甲状旁腺切除术的患者从病例系列的机构电子数据库中确定。所有研究都进行了敏感性分析,特异性,阳性预测值(PPV),和阴性预测值(NPV)的4DCT腺瘤定位能力。
结果:确定并分析了包括379例患者的13项回顾性研究和包括37例患者的1项病例系列。对每个患者的分析显示,在固定效应模型为89%(95%置信区间[CI]:82%-93%)的情况下,对正确侧(n=181)的侧向敏感性在80%至100%之间,并且在随机效应模型为87%(95%CI:77%-95%)的情况下,侧向的PPV在63%-95%之间。定位对正确象限(n=172)的敏感性范围为53%至100%,随机效应模型为90.4%(95%CI:76%-99%),定位的PPV范围为52%至100%,随机效应模型为82%(95%CI:73%-89%)。
结论:4DCT增强了在不一致或非定位US和MIBI扫描的情况下定位PTA的成像能力。
方法:NA喉镜,134:2198-2205,2024。
OBJECTIVE: To evaluate the accuracy of four-dimensional computerized-tomography (4DCT) for localizing parathyroid adenomas (PTAs) in cases with discordant or non-localizing ultrasonography (US) and Technetium-99 sestamibi (MIBI) scans.
METHODS: Retrospective
case series and systematic review.
METHODS: A
case series and meta-analysis of patients diagnosed with primary hyperparathyroidism and discordant US and MIBI scans who underwent 4DCT prior to surgery. A comprehensive search for all relevant publications in the English literature between December 2006 and March 2022 was conducted for the meta-analysis. Patients undergoing parathyroidectomy between January 2015 and December 2021 were identified from the institutional electronic database for the
case series. All studies were analyzed for sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of the 4DCT adenoma localization capabilities.
RESULTS: Thirteen retrospective studies that included 379 patients and one
case series that included 37 patients were identified and analyzed. A per-patient analysis revealed sensitivity for lateralization to the correct side (n = 181) ranging from 80% to 100% with a fixed effects model of 89% (95%confidence interval [CI]: 82%-93%) and a PPV for lateralization ranging from 63%-95% with a random effects model of 87% (95% CI: 77%-95%). Sensitivity of localization to the correct quadrant (n = 172) ranged from 53% to 100% with a random effects model of 90.4% (95% CI: 76%-99%), and the PPV for localization ranged from 52% to 100% with a random effects model of 82% (95% CI: 73%-89%).
CONCLUSIONS: 4DCT enhances imaging capabilities of localizing PTAs in cases of discordant or non-localizing US and MIBI scans.
METHODS: NA Laryngoscope, 134:2198-2205, 2024.