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 探讨继发性肺结核合并肺部真菌感染的临床特点及相关高危因素。方法 收集广州市胸科医院2017年7月—2019年10月收治的继发性肺结核患者资料,病程均大于3个月,分为真菌感染组106例和非真菌感染组100例进行回顾性分析。结果 单因素分析结果显示,合并肺部其他疾病、非初治、咯血、空洞、应用广谱抗生素>l周、侵袭性操作存在统计学差异(P<0.05)。Logistic多因素分析结果显示,广谱抗生素使用>l周、侵袭性操作为真菌感染的独立危险因素(P<0.05)。结论 对于应用广谱抗生素、进行侵袭性操作的肺结核患者应警惕真菌感染风险,及早预防及诊治。

Objective To investigate the clinical characteristics and related high risk factors of secondary pulmonary tuberculosis complicated with pulmonary fungal infection. Methods Data of patients with secondary tuberculosis admitted to Guangzhou Chest Hospital from July 2017 to October 2019 were collected. All patients with a course of disease longer than 3 months were divided into the fungal infection group (n =106) and the non-fungal infection group (n =100) for retrospective analysis. Results Univariate analysis results showed that there were statistical differences in combined other pulmonary diseases, non-initial treatment, hemoptysis, cavity, application of broad-spectrum antibiotic > for 1 week, and invasive operation (P<0.05). Logistic multivariate analysis showed that >1 week of broad-spectrum antibiotics and invasive procedures were independent risk factors for fungal infection (P<0.05). Conclusion Patients with tuberculosis who are treated with broad-spectrum antibiotics and invasive procedures should be alert to the risk of fungal infection, early prevention and treatment should be undertaken.

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。