摘要：目的 探讨甲状旁腺激素测定对尿毒症透析患者甲状旁腺SPECT/CT显像的临床价值。方法 对63例尿毒症长期透析患者在透析前行甲状旁腺激素测定，99Tcm-MIBI早期及延迟甲状旁腺平面显像，并在延迟显像时行SPECT断层显像及同机CT扫描并进行图像融合，分析甲状旁腺激素水平与甲状旁腺显像及同机CT扫描间的关系。结果 早期平面显像显示甲状腺影像，延迟平面显像阳性率61.90% (39/63)；断层显像及图像融合66.67%（42/63）。42例显像阳性患者PTH均值为（1509.91± 614.25）ng/mL，其中19例显像阳性接受手术患者PTH均值为（1423.37±520.49）ng/mL，其余23例PTH结果为（1538.61±572.93）ng/mL，二者比较差异无统计学意义（P>0.05）；21例显像阴性患者PTH均值为（944.21±721.43）ng/mL，与显像阳性患者的PTH值比较，差异具有统计学意义(P <0.01)。结论 根据长期透析尿毒症患者的PTH水平，有选择的行99Tcm-MIBI甲状旁腺SPECT/CT融合显像，能更有针对性的发现病灶并对病灶进行定位，较常规平面和断层显像有更高的诊断价值。

Abstract: Objective To investigate the clinical application value of parathyroid hormone levels in uremic hemodialysis patients with parathyroid 99Tcm-MIBI SPECT/CT fusion imaging. Methods The serum parathyroid hormone levels in 63 uremic patients before hemodialysis were measured, and then all patients accepted parathyroid 99Tcm-MIBI SPECT/CT planar imaging at 10 min and 120 min post-injection, additional tomography and CT scan fusion imaging at 120 min post-injection. The relevance between the parathyroid hormone serum levels and SPECT/CT imaging results was analyzed. Results The early planar imaging showed the thyroid images, and the delay planar imaging showed a positive rate of 61.90% (39/63). The positive rate of tomography and fusion imaging was 66.67% (42/63). The mean levels of serum parathyroid hormone (PTH) in 42 parathyroid imaging positive patients were 1509.91± 614.25 ng/mL. The mean levels of serum parathyroid hormone in 19 patients confirmed by surgery operation and the other 23 patients were 1423.37±520.49 ng/mL and 1538.61±572.93 ng/mL respectively. There was no statistically significant difference between them (P>0.05). The mean serum PTH levels in 21 negative imaging patients was 944.21±721.43 ng/mL, there was a statistically significant difference compared with the 42 positive imaging patients (P<0.01). Conclusion The suspicious uremic hemodialysis patient based on the parathyroid hormone serum levels adapted to parathyroid 99Tcm-MIBI SPECT/CT could improve the examination positive rate and locate the lesions for surgery. The 99Tcm-MIBI SPECT/CT fusion imaging has more diagnostic value compared with the route planar and tomography imaging.