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CZECH MEDICAL ASSOCIATION J. Ev. PURKYNĚ |
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Česky / Czech version | Vnitř. Lék., 50, 2004, No. 1, p. 72 - 75 |
Mismatch of Scintigraphies with 99mTc-MIBI
and 99mTc-pertechnetate in a Patient with Hyperparathyroidism Doležal J.1, Horáček J.3, Ceeová V.2, Vižďa J.1 1Oddělení nukleární medicíny FN, Hradec Králové, přednosta MUDr. Ing. Jaroslav Vižďa 2II. interní klinika Lékařské fakulty UK a FN, Hradec Králové, přednosta prof. MUDr. Jaroslav Malý, CSc. 3Katedra interních oborů Lékařské fakulty UK, Hradec Králové, přednosta prof. MUDr. Jaroslav Malý, CSc. |
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Summary: Sixty-two-year-old man was admitted to hospital for increased serum level of calcium (3.85
mmol/l) and incipient renal failure (urea 7.2 mmol/l, kreatinin 117 mol/l). The reason of hypercalcaemia
was intensive explored. Serum level of intact PTH was 383.6 pg/ml. We performed two-dimensional
early and delayed (2 hours) scintigram after intravenous administration of 750 MBq
99mTc-sestamibi, i.e. double-phase technique. There was detected focus (diameter 20 mm) of increased
sestamibi uptake with slow wash-out in distal part right thyroid lobe. Planar scintigraphy
obtained after intravenous administration of 185 MBq 99mTc-pertechnetate detected focus of increased
99mTc-pertechnetate uptake in the same point too. Patient underwent right thyroid lobectomy.
There was colloid nodular goiter. Under right thyroid lobe was detected spherical particle.
This particle was ablated (diameter 20 mm, weight 4 gram). It was parathyroid adenoma. One
month after ablation of parathyroid adenoma serum level of PTH was 23.1 pg/ml and serum level
of calcium was 2.52 mmol/l. There was overlap of scintigraphy image of parathyroid adenoma
under distal part of right thyroid lobe on 99mTc-sestamibi two-dimensional scintigram and scintigraphy
image of hyperplastic node with increased activity in distal part of right thyroid lobe on
99mTc-pertechnetate two-dimensional scintigram.
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