甲状旁腺增生的MSCT表现

发布时间：2018-06-24 13:49

本文选题：甲状旁腺增生 + 原发性甲状旁腺功能亢进　；参考：《临床放射学杂志》2017年11期

【摘要】：目的探讨甲状旁腺增生(PH)的多层螺旋CT(MSCT)表现,提高诊断正确率,减少漏诊。方法回顾性分析47例经手术及病理证实的PH患者的MSCT资料,并纳入实验组,对PH的发生部位、形态学特征、强化特点及周围毗邻关系进行分析,同期8例甲状旁腺腺瘤(PA)患者设为对照组,比较两组MSCT表现的异同。结果 47例PH患者中,CT检出病灶158个,与手术结果(n=175)的符合率为90.3%。CT测量PH病灶的面积在0.21~6.72 cm~2之间。原发性甲状旁腺功能亢进(PHPT)与继发性甲状旁腺功能亢进(SHPT)患者在PH病灶的面积(t=-0.918,P=0.3600.05)上进行比较,差异无统计学意义,但二者在血清磷的浓度(t=4.693,P=0.0000.05)上进行比较,差异有统计学意义。47例PH单侧或双侧均可发生,双侧发生多见,且形态不对称。病灶形态呈类圆形或椭圆形,平扫呈软组织密度,无出血、囊变或坏死。PHPT患者的PH无钙化;SHPT患者的PH钙化发生率为60.5%;PH造成骨骼改变表现为多发囊性改变和/或毛玻璃片样改变。PH的动态增强扫描时间-密度曲线为缓慢上升型和速升缓降型。病理上PH与PA在病灶最大径(t=-3.792,P=0.0000.05)上进行比较,差异有统计学意义,其他鉴别在平扫及增强图像上差异不大。结论 PH发生特定的解剖区域,单发或双侧不对称发生,SHPT患者的PH的钙化率及骨骼改变发生率较高,CT增强扫描有助于PH的识别。
[Abstract]:Objective to investigate the multi-slice spiral CT (MSCT) findings of parathyroid hyperplasia (PH) to improve the diagnostic accuracy and reduce missed diagnosis. Methods the MSCT data of 47 patients with PH proved by surgery and pathology were retrospectively analyzed and included in the experimental group. The location, morphology, enhancement and adjacent relationship of PH were analyzed. Eight patients with parathyroid adenoma (PA) were divided into two groups. Results 158 lesions were detected by CT in 47 patients with PH. The coincidence rate between CT and surgical results (nm175) was 90.33. Ct measurement of PH lesions was between 0.21 and 6.72 cm~2. There was no significant difference between primary hyperparathyroidism (PHPT) and secondary hyperparathyroidism (SHPT) in the area of PH lesion (t _ (-0.918) P _ (0.3600.05), but there was no significant difference between them in serum phosphorus concentration (t _ (4.693) P _ (0.0000.05). The difference was statistically significant in 47 cases with PH both unilateral and bilateral. The lesions were round or oval in shape, soft tissue density was observed in plain scan, and there was no bleeding. The incidence of PH calcification in patients with PH without calcification in patients with cystic or necrotic PHPT is 60.5%. The bone changes caused by PH are characterized by multiple cystic changes and / or glass-like changes. The time-density curve of dynamic contrast-enhanced scanning of PH is increasing slowly. Type A and quick rise and slow descent. The difference between PH and PA was statistically significant in the maximum diameter of the lesion (t ~ (-3.792) P ~ (0.0000.05), but there was no significant difference between the other differential images on plain scan and contrast enhancement. Conclusion the calcification rate and bone change rate of PH in patients with single or bilateral asymmetrical occurrence of SHPT are higher than that of CT enhanced CT scan is helpful to the recognition of PH. Conclusion the specific anatomical area of PH occurs and the rate of PH calcification and bone change is higher in patients with single or bilateral asymmetries.
【作者单位】：南京医科大学附属无锡人民医院医学影像科;
【分类号】：R582;R816.6

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