本文選題：甲狀旁腺增生 + 原發(fā)性甲狀旁腺功能亢進(jìn)�。� 參考：《臨床放射學(xué)雜志》2017年11期

【摘要】：目的探討甲狀旁腺增生(PH)的多層螺旋CT(MSCT)表現(xiàn),提高診斷正確率,減少漏診。方法回顧性分析47例經(jīng)手術(shù)及病理證實(shí)的PH患者的MSCT資料,并納入實(shí)驗(yàn)組,對(duì)PH的發(fā)生部位、形態(tài)學(xué)特征、強(qiáng)化特點(diǎn)及周圍毗鄰關(guān)系進(jìn)行分析,同期8例甲狀旁腺腺瘤(PA)患者設(shè)為對(duì)照組,比較兩組MSCT表現(xiàn)的異同。結(jié)果 47例PH患者中,CT檢出病灶158個(gè),與手術(shù)結(jié)果(n=175)的符合率為90.3%。CT測(cè)量PH病灶的面積在0.21~6.72 cm~2之間。原發(fā)性甲狀旁腺功能亢進(jìn)(PHPT)與繼發(fā)性甲狀旁腺功能亢進(jìn)(SHPT)患者在PH病灶的面積(t=-0.918,P=0.3600.05)上進(jìn)行比較,差異無統(tǒng)計(jì)學(xué)意義,但二者在血清磷的濃度(t=4.693,P=0.0000.05)上進(jìn)行比較,差異有統(tǒng)計(jì)學(xué)意義。47例PH單側(cè)或雙側(cè)均可發(fā)生,雙側(cè)發(fā)生多見,且形態(tài)不對(duì)稱。病灶形態(tài)呈類圓形或橢圓形,平掃呈軟組織密度,無出血、囊變或壞死。PHPT患者的PH無鈣化;SHPT患者的PH鈣化發(fā)生率為60.5%;PH造成骨骼改變表現(xiàn)為多發(fā)囊性改變和/或毛玻璃片樣改變。PH的動(dòng)態(tài)增強(qiáng)掃描時(shí)間-密度曲線為緩慢上升型和速升緩降型。病理上PH與PA在病灶最大徑(t=-3.792,P=0.0000.05)上進(jìn)行比較,差異有統(tǒng)計(jì)學(xué)意義,其他鑒別在平掃及增強(qiáng)圖像上差異不大。結(jié)論 PH發(fā)生特定的解剖區(qū)域,單發(fā)或雙側(cè)不對(duì)稱發(fā)生,SHPT患者的PH的鈣化率及骨骼改變發(fā)生率較高,CT增強(qiáng)掃描有助于PH的識(shí)別。
[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.
【作者單位】： 南京醫(yī)科大學(xué)附屬無錫人民醫(yī)院醫(yī)學(xué)影像科;
【分類號(hào)】：R582;R816.6

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