目的 比较锝[???Tc]甲氧基异丁基异腈单光子发射计算机断层扫描/计算机断层扫描（???Tc-MIBI SPECT/CT）双时相显像与颈部超声在继发性甲状旁腺功能亢进症（SHPT）患者术前定位中的诊断价值。方法 回顾性纳入2025年5月至2026年4月于黔东南苗族侗族自治州人民医院行两种影像学检查的疑似SHPT患者54例。以手术病理结果为金标准，计算超声与SPECT/CT在区域层面（共216个区域）的敏感性、特异性、准确性，并比较不同解剖区域的病灶检出率。结果 54例中确诊SHPT 45例（83.33%）。超声诊断敏感性、特异性、准确性分别为70.89%（112/158）、86.21%（50/58）、75.00%（162/216）；SPECT/CT分别为92.41%（146/158）、94.83%（55/58）、93.06%（201/216）。SPECT/CT的敏感性和准确性均高于超声（P均<0.001）。SPECT/CT在左上、左下、右上三个区域的检出率均高于超声（P<0.05）。结论 99mTc-MIBI SPECT/CT双时相显像在SHPT术前定位中的敏感性和准确性优于颈部超声，尤其对左上、左下、右上区域病灶检出优势明显，可作为SHPT患者术前定位的重要补充或首选影像学方法。

Objective?To compare the diagnostic value of technetium-99m methoxyisobutylisonitrile single-photon emission computed tomography/computed tomography (99mTc-MIBI SPECT/CT) dual-phase imaging and cervical ultrasound in preoperative localization of secondary hyperparathyroidism (SHPT).?Methods?A total of 54 patients with suspected SHPT who underwent both imaging examinations at Qiandongnan Miao and Dong Autonomous Prefecture People's Hospital from May 2025 to April 2026 were retrospectively enrolled. Using surgical pathology as the gold standard, the sensitivity, specificity, and accuracy of ultrasound and SPECT/CT were calculated at the regional level (216 regions in total), and the detection rates in different anatomical regions were compared.?Results?Among the 54 patients, 45 (83.33%) were confirmed with SHPT. The sensitivity, specificity, and accuracy of ultrasound were 70.89% (112/158), 86.21% (50/58), and 75.00% (162/216), respectively; while those of SPECT/CT were 92.41% (146/158), 94.83% (55/58), and 93.06% (201/216), respectively. The sensitivity and accuracy of SPECT/CT were significantly higher than those of ultrasound (both?P<0.001). The detection rates of SPECT/CT in the upper-left, lower-left, and upper-right regions were significantly higher than those of ultrasound (P<0.05).?Conclusion?99mTc-MIBI SPECT/CT dual-phase imaging demonstrates superior sensitivity and accuracy compared with cervical ultrasound in preoperative localization of SHPT, especially showing significant advantages in detecting lesions in the upper-left, lower-left, and upper-right regions. It can serve as an important supplement or the first-choice imaging modality for preoperative localization in SHPT patients.

目的 比较锝[???Tc]甲氧基异丁基异腈单光子发射计算机断层扫描/计算机断层扫描（???Tc-MIBI SPECT/CT）双时相显像与颈部超声在继发性甲状旁腺功能亢进症（SHPT）患者术前定位中的诊断价值。方法 回顾性纳入2025年5月至2026年4月于黔东南苗族侗族自治州人民医院行两种影像学检查的疑似SHPT患者54例。以手术病理结果为金标准，计算超声与SPECT/CT在区域层面（共216个区域）的敏感性、特异性、准确性，并比较不同解剖区域的病灶检出率。结果 54例中确诊SHPT 45例（83.33%）。超声诊断敏感性、特异性、准确性分别为70.89%（112/158）、86.21%（50/58）、75.00%（162/216）；SPECT/CT分别为92.41%（146/158）、94.83%（55/58）、93.06%（201/216）。SPECT/CT的敏感性和准确性均高于超声（P均<0.001）。SPECT/CT在左上、左下、右上三个区域的检出率均高于超声（P<0.05）。结论 99mTc-MIBI SPECT/CT双时相显像在SHPT术前定位中的敏感性和准确性优于颈部超声，尤其对左上、左下、右上区域病灶检出优势明显，可作为SHPT患者术前定位的重要补充或首选影像学方法。

Objective?To compare the diagnostic value of technetium-99m methoxyisobutylisonitrile single-photon emission computed tomography/computed tomography (99mTc-MIBI SPECT/CT) dual-phase imaging and cervical ultrasound in preoperative localization of secondary hyperparathyroidism (SHPT).?Methods?A total of 54 patients with suspected SHPT who underwent both imaging examinations at Qiandongnan Miao and Dong Autonomous Prefecture People's Hospital from May 2025 to April 2026 were retrospectively enrolled. Using surgical pathology as the gold standard, the sensitivity, specificity, and accuracy of ultrasound and SPECT/CT were calculated at the regional level (216 regions in total), and the detection rates in different anatomical regions were compared.?Results?Among the 54 patients, 45 (83.33%) were confirmed with SHPT. The sensitivity, specificity, and accuracy of ultrasound were 70.89% (112/158), 86.21% (50/58), and 75.00% (162/216), respectively; while those of SPECT/CT were 92.41% (146/158), 94.83% (55/58), and 93.06% (201/216), respectively. The sensitivity and accuracy of SPECT/CT were significantly higher than those of ultrasound (both?P<0.001). The detection rates of SPECT/CT in the upper-left, lower-left, and upper-right regions were significantly higher than those of ultrasound (P<0.05).?Conclusion?99mTc-MIBI SPECT/CT dual-phase imaging demonstrates superior sensitivity and accuracy compared with cervical ultrasound in preoperative localization of SHPT, especially showing significant advantages in detecting lesions in the upper-left, lower-left, and upper-right regions. It can serve as an important supplement or the first-choice imaging modality for preoperative localization in SHPT patients.

目的 比较锝[???Tc]甲氧基异丁基异腈单光子发射计算机断层扫描/计算机断层扫描（???Tc-MIBI SPECT/CT）双时相显像与颈部超声在继发性甲状旁腺功能亢进症（SHPT）患者术前定位中的诊断价值。方法 回顾性纳入2025年5月至2026年4月于黔东南苗族侗族自治州人民医院行两种影像学检查的疑似SHPT患者54例。以手术病理结果为金标准，计算超声与SPECT/CT在区域层面（共216个区域）的敏感性、特异性、准确性，并比较不同解剖区域的病灶检出率。结果 54例中确诊SHPT 45例（83.33%）。超声诊断敏感性、特异性、准确性分别为70.89%（112/158）、86.21%（50/58）、75.00%（162/216）；SPECT/CT分别为92.41%（146/158）、94.83%（55/58）、93.06%（201/216）。SPECT/CT的敏感性和准确性均高于超声（P均<0.001）。SPECT/CT在左上、左下、右上三个区域的检出率均高于超声（P<0.05）。结论 99mTc-MIBI SPECT/CT双时相显像在SHPT术前定位中的敏感性和准确性优于颈部超声，尤其对左上、左下、右上区域病灶检出优势明显，可作为SHPT患者术前定位的重要补充或首选影像学方法。

Objective?To compare the diagnostic value of technetium-99m methoxyisobutylisonitrile single-photon emission computed tomography/computed tomography (99mTc-MIBI SPECT/CT) dual-phase imaging and cervical ultrasound in preoperative localization of secondary hyperparathyroidism (SHPT).?Methods?A total of 54 patients with suspected SHPT who underwent both imaging examinations at Qiandongnan Miao and Dong Autonomous Prefecture People's Hospital from May 2025 to April 2026 were retrospectively enrolled. Using surgical pathology as the gold standard, the sensitivity, specificity, and accuracy of ultrasound and SPECT/CT were calculated at the regional level (216 regions in total), and the detection rates in different anatomical regions were compared.?Results?Among the 54 patients, 45 (83.33%) were confirmed with SHPT. The sensitivity, specificity, and accuracy of ultrasound were 70.89% (112/158), 86.21% (50/58), and 75.00% (162/216), respectively; while those of SPECT/CT were 92.41% (146/158), 94.83% (55/58), and 93.06% (201/216), respectively. The sensitivity and accuracy of SPECT/CT were significantly higher than those of ultrasound (both?P<0.001). The detection rates of SPECT/CT in the upper-left, lower-left, and upper-right regions were significantly higher than those of ultrasound (P<0.05).?Conclusion?99mTc-MIBI SPECT/CT dual-phase imaging demonstrates superior sensitivity and accuracy compared with cervical ultrasound in preoperative localization of SHPT, especially showing significant advantages in detecting lesions in the upper-left, lower-left, and upper-right regions. It can serve as an important supplement or the first-choice imaging modality for preoperative localization in SHPT patients.

目的 比较锝[???Tc]甲氧基异丁基异腈单光子发射计算机断层扫描/计算机断层扫描（???Tc-MIBI SPECT/CT）双时相显像与颈部超声在继发性甲状旁腺功能亢进症（SHPT）患者术前定位中的诊断价值。方法 回顾性纳入2025年5月至2026年4月于黔东南苗族侗族自治州人民医院行两种影像学检查的疑似SHPT患者54例。以手术病理结果为金标准，计算超声与SPECT/CT在区域层面（共216个区域）的敏感性、特异性、准确性，并比较不同解剖区域的病灶检出率。结果 54例中确诊SHPT 45例（83.33%）。超声诊断敏感性、特异性、准确性分别为70.89%（112/158）、86.21%（50/58）、75.00%（162/216）；SPECT/CT分别为92.41%（146/158）、94.83%（55/58）、93.06%（201/216）。SPECT/CT的敏感性和准确性均高于超声（P均<0.001）。SPECT/CT在左上、左下、右上三个区域的检出率均高于超声（P<0.05）。结论 99mTc-MIBI SPECT/CT双时相显像在SHPT术前定位中的敏感性和准确性优于颈部超声，尤其对左上、左下、右上区域病灶检出优势明显，可作为SHPT患者术前定位的重要补充或首选影像学方法。

Objective?To compare the diagnostic value of technetium-99m methoxyisobutylisonitrile single-photon emission computed tomography/computed tomography (99mTc-MIBI SPECT/CT) dual-phase imaging and cervical ultrasound in preoperative localization of secondary hyperparathyroidism (SHPT).?Methods?A total of 54 patients with suspected SHPT who underwent both imaging examinations at Qiandongnan Miao and Dong Autonomous Prefecture People's Hospital from May 2025 to April 2026 were retrospectively enrolled. Using surgical pathology as the gold standard, the sensitivity, specificity, and accuracy of ultrasound and SPECT/CT were calculated at the regional level (216 regions in total), and the detection rates in different anatomical regions were compared.?Results?Among the 54 patients, 45 (83.33%) were confirmed with SHPT. The sensitivity, specificity, and accuracy of ultrasound were 70.89% (112/158), 86.21% (50/58), and 75.00% (162/216), respectively; while those of SPECT/CT were 92.41% (146/158), 94.83% (55/58), and 93.06% (201/216), respectively. The sensitivity and accuracy of SPECT/CT were significantly higher than those of ultrasound (both?P<0.001). The detection rates of SPECT/CT in the upper-left, lower-left, and upper-right regions were significantly higher than those of ultrasound (P<0.05).?Conclusion?99mTc-MIBI SPECT/CT dual-phase imaging demonstrates superior sensitivity and accuracy compared with cervical ultrasound in preoperative localization of SHPT, especially showing significant advantages in detecting lesions in the upper-left, lower-left, and upper-right regions. It can serve as an important supplement or the first-choice imaging modality for preoperative localization in SHPT patients.

目的 比较锝[???Tc]甲氧基异丁基异腈单光子发射计算机断层扫描/计算机断层扫描（???Tc-MIBI SPECT/CT）双时相显像与颈部超声在继发性甲状旁腺功能亢进症（SHPT）患者术前定位中的诊断价值。方法 回顾性纳入2025年5月至2026年4月于黔东南苗族侗族自治州人民医院行两种影像学检查的疑似SHPT患者54例。以手术病理结果为金标准，计算超声与SPECT/CT在区域层面（共216个区域）的敏感性、特异性、准确性，并比较不同解剖区域的病灶检出率。结果 54例中确诊SHPT 45例（83.33%）。超声诊断敏感性、特异性、准确性分别为70.89%（112/158）、86.21%（50/58）、75.00%（162/216）；SPECT/CT分别为92.41%（146/158）、94.83%（55/58）、93.06%（201/216）。SPECT/CT的敏感性和准确性均高于超声（P均<0.001）。SPECT/CT在左上、左下、右上三个区域的检出率均高于超声（P<0.05）。结论 99mTc-MIBI SPECT/CT双时相显像在SHPT术前定位中的敏感性和准确性优于颈部超声，尤其对左上、左下、右上区域病灶检出优势明显，可作为SHPT患者术前定位的重要补充或首选影像学方法。

Objective?To compare the diagnostic value of technetium-99m methoxyisobutylisonitrile single-photon emission computed tomography/computed tomography (99mTc-MIBI SPECT/CT) dual-phase imaging and cervical ultrasound in preoperative localization of secondary hyperparathyroidism (SHPT).?Methods?A total of 54 patients with suspected SHPT who underwent both imaging examinations at Qiandongnan Miao and Dong Autonomous Prefecture People's Hospital from May 2025 to April 2026 were retrospectively enrolled. Using surgical pathology as the gold standard, the sensitivity, specificity, and accuracy of ultrasound and SPECT/CT were calculated at the regional level (216 regions in total), and the detection rates in different anatomical regions were compared.?Results?Among the 54 patients, 45 (83.33%) were confirmed with SHPT. The sensitivity, specificity, and accuracy of ultrasound were 70.89% (112/158), 86.21% (50/58), and 75.00% (162/216), respectively; while those of SPECT/CT were 92.41% (146/158), 94.83% (55/58), and 93.06% (201/216), respectively. The sensitivity and accuracy of SPECT/CT were significantly higher than those of ultrasound (both?P<0.001). The detection rates of SPECT/CT in the upper-left, lower-left, and upper-right regions were significantly higher than those of ultrasound (P<0.05).?Conclusion?99mTc-MIBI SPECT/CT dual-phase imaging demonstrates superior sensitivity and accuracy compared with cervical ultrasound in preoperative localization of SHPT, especially showing significant advantages in detecting lesions in the upper-left, lower-left, and upper-right regions. It can serve as an important supplement or the first-choice imaging modality for preoperative localization in SHPT patients.

目的 比较锝[???Tc]甲氧基异丁基异腈单光子发射计算机断层扫描/计算机断层扫描（???Tc-MIBI SPECT/CT）双时相显像与颈部超声在继发性甲状旁腺功能亢进症（SHPT）患者术前定位中的诊断价值。方法 回顾性纳入2025年5月至2026年4月于黔东南苗族侗族自治州人民医院行两种影像学检查的疑似SHPT患者54例。以手术病理结果为金标准，计算超声与SPECT/CT在区域层面（共216个区域）的敏感性、特异性、准确性，并比较不同解剖区域的病灶检出率。结果 54例中确诊SHPT 45例（83.33%）。超声诊断敏感性、特异性、准确性分别为70.89%（112/158）、86.21%（50/58）、75.00%（162/216）；SPECT/CT分别为92.41%（146/158）、94.83%（55/58）、93.06%（201/216）。SPECT/CT的敏感性和准确性均高于超声（P均<0.001）。SPECT/CT在左上、左下、右上三个区域的检出率均高于超声（P<0.05）。结论 99mTc-MIBI SPECT/CT双时相显像在SHPT术前定位中的敏感性和准确性优于颈部超声，尤其对左上、左下、右上区域病灶检出优势明显，可作为SHPT患者术前定位的重要补充或首选影像学方法。

Objective?To compare the diagnostic value of technetium-99m methoxyisobutylisonitrile single-photon emission computed tomography/computed tomography (99mTc-MIBI SPECT/CT) dual-phase imaging and cervical ultrasound in preoperative localization of secondary hyperparathyroidism (SHPT).?Methods?A total of 54 patients with suspected SHPT who underwent both imaging examinations at Qiandongnan Miao and Dong Autonomous Prefecture People's Hospital from May 2025 to April 2026 were retrospectively enrolled. Using surgical pathology as the gold standard, the sensitivity, specificity, and accuracy of ultrasound and SPECT/CT were calculated at the regional level (216 regions in total), and the detection rates in different anatomical regions were compared.?Results?Among the 54 patients, 45 (83.33%) were confirmed with SHPT. The sensitivity, specificity, and accuracy of ultrasound were 70.89% (112/158), 86.21% (50/58), and 75.00% (162/216), respectively; while those of SPECT/CT were 92.41% (146/158), 94.83% (55/58), and 93.06% (201/216), respectively. The sensitivity and accuracy of SPECT/CT were significantly higher than those of ultrasound (both?P<0.001). The detection rates of SPECT/CT in the upper-left, lower-left, and upper-right regions were significantly higher than those of ultrasound (P<0.05).?Conclusion?99mTc-MIBI SPECT/CT dual-phase imaging demonstrates superior sensitivity and accuracy compared with cervical ultrasound in preoperative localization of SHPT, especially showing significant advantages in detecting lesions in the upper-left, lower-left, and upper-right regions. It can serve as an important supplement or the first-choice imaging modality for preoperative localization in SHPT patients.

目的 比较锝[???Tc]甲氧基异丁基异腈单光子发射计算机断层扫描/计算机断层扫描（???Tc-MIBI SPECT/CT）双时相显像与颈部超声在继发性甲状旁腺功能亢进症（SHPT）患者术前定位中的诊断价值。方法 回顾性纳入2025年5月至2026年4月于黔东南苗族侗族自治州人民医院行两种影像学检查的疑似SHPT患者54例。以手术病理结果为金标准，计算超声与SPECT/CT在区域层面（共216个区域）的敏感性、特异性、准确性，并比较不同解剖区域的病灶检出率。结果 54例中确诊SHPT 45例（83.33%）。超声诊断敏感性、特异性、准确性分别为70.89%（112/158）、86.21%（50/58）、75.00%（162/216）；SPECT/CT分别为92.41%（146/158）、94.83%（55/58）、93.06%（201/216）。SPECT/CT的敏感性和准确性均高于超声（P均<0.001）。SPECT/CT在左上、左下、右上三个区域的检出率均高于超声（P<0.05）。结论 99mTc-MIBI SPECT/CT双时相显像在SHPT术前定位中的敏感性和准确性优于颈部超声，尤其对左上、左下、右上区域病灶检出优势明显，可作为SHPT患者术前定位的重要补充或首选影像学方法。

Objective?To compare the diagnostic value of technetium-99m methoxyisobutylisonitrile single-photon emission computed tomography/computed tomography (99mTc-MIBI SPECT/CT) dual-phase imaging and cervical ultrasound in preoperative localization of secondary hyperparathyroidism (SHPT).?Methods?A total of 54 patients with suspected SHPT who underwent both imaging examinations at Qiandongnan Miao and Dong Autonomous Prefecture People's Hospital from May 2025 to April 2026 were retrospectively enrolled. Using surgical pathology as the gold standard, the sensitivity, specificity, and accuracy of ultrasound and SPECT/CT were calculated at the regional level (216 regions in total), and the detection rates in different anatomical regions were compared.?Results?Among the 54 patients, 45 (83.33%) were confirmed with SHPT. The sensitivity, specificity, and accuracy of ultrasound were 70.89% (112/158), 86.21% (50/58), and 75.00% (162/216), respectively; while those of SPECT/CT were 92.41% (146/158), 94.83% (55/58), and 93.06% (201/216), respectively. The sensitivity and accuracy of SPECT/CT were significantly higher than those of ultrasound (both?P<0.001). The detection rates of SPECT/CT in the upper-left, lower-left, and upper-right regions were significantly higher than those of ultrasound (P<0.05).?Conclusion?99mTc-MIBI SPECT/CT dual-phase imaging demonstrates superior sensitivity and accuracy compared with cervical ultrasound in preoperative localization of SHPT, especially showing significant advantages in detecting lesions in the upper-left, lower-left, and upper-right regions. It can serve as an important supplement or the first-choice imaging modality for preoperative localization in SHPT patients.

目的 比较锝[???Tc]甲氧基异丁基异腈单光子发射计算机断层扫描/计算机断层扫描（???Tc-MIBI SPECT/CT）双时相显像与颈部超声在继发性甲状旁腺功能亢进症（SHPT）患者术前定位中的诊断价值。方法 回顾性纳入2025年5月至2026年4月于黔东南苗族侗族自治州人民医院行两种影像学检查的疑似SHPT患者54例。以手术病理结果为金标准，计算超声与SPECT/CT在区域层面（共216个区域）的敏感性、特异性、准确性，并比较不同解剖区域的病灶检出率。结果 54例中确诊SHPT 45例（83.33%）。超声诊断敏感性、特异性、准确性分别为70.89%（112/158）、86.21%（50/58）、75.00%（162/216）；SPECT/CT分别为92.41%（146/158）、94.83%（55/58）、93.06%（201/216）。SPECT/CT的敏感性和准确性均高于超声（P均<0.001）。SPECT/CT在左上、左下、右上三个区域的检出率均高于超声（P<0.05）。结论 99mTc-MIBI SPECT/CT双时相显像在SHPT术前定位中的敏感性和准确性优于颈部超声，尤其对左上、左下、右上区域病灶检出优势明显，可作为SHPT患者术前定位的重要补充或首选影像学方法。

目的 探讨甲状旁腺全切除加前臂自身移植术(tPTX+AT)对并发继发性甲状旁腺功能亢进(SHPT)的尿毒症患者心脏功能的影响。方法 将50例接受tPTX+AT治疗的尿毒症并发SHPT患者作为手术组,并配对选择50例同期未接受手术治疗的尿毒症并发SHPT患者作为非手术组。对所有患者进行12个月的随访,分析两组随访过程中心室结构、心脏功能及甲状旁腺功能相关指标的变化情况。结果 在随访过程中,手术组LVD、IVSS、LVPWT、NT-proBNP、iPTH、Ga及P均呈现降低趋势,LVEF呈现升高趋势(P<0.05);非手术组LVEF、iPTH及Ga呈现升高趋势,LVD、IVSS、LVPWT、NT-proBNP及P呈现降低趋势(P<0.05)。在随访6个月及随访12个月时,手术组LVD、IVSS、LVPWT、NT-proBNP、iPTH、Ga及P低于非手术组,LVEF高于非手术组(P<0.05)。结论 tPTX+AT可有效的改善尿毒症并发SHPT患者的心室结构及心脏功能,并可在一定程度上改善患者的甲状旁腺功能。

目的 探究尿毒症继发性甲状旁腺功能亢进经甲状旁腺切除术治疗效果及安全性分析。方法 选取2017年6月—2019年5月于我院就诊的90例尿毒症继发性甲状旁腺功能亢进患者为研究对象,随机分为对照组与观察组,两组各45例。均采取同一药物治疗,对照组行次全切除治疗,观察组行甲状旁腺全切除术+前臂移植术。对比分析两组治疗效果、血生化指标及并发症。结果 观察组疗效优于对照组(P<0.05);观察组术后1周、1个月钙、iPTH、磷、钙磷乘积及ALP水平均低于对照组(P<0.05);观察组并发症发生率低于对照组(P<0.05)。结论 甲状旁腺全切除+前臂移植治疗尿毒症继发性甲状旁腺功能亢进疗效显著,并发症风险低,值得推广。