| 张勇,邱传亚,徐先发,薛彩霞,蒋珊珊.多种影像学方法术前诊断继发性甲状旁腺功能亢进症增生结节[J].中国医学影像技术,2021,37(2):206~210 |
| 多种影像学方法术前诊断继发性甲状旁腺功能亢进症增生结节 |
| Multiple imaging methods in preoperative diagnosis of hyperplastic nodules in secondary hyperparathyroidism |
| 投稿时间：2020-01-20 修订日期：2020-09-22 |
| DOI：10.13929/j.issn.1003-3289.2021.02.010 |
| 中文关键词: 甲状旁腺功能亢进,继发性 增生 诊断显像 |
| 英文关键词:hyperparathyroidism, secondary hyperplasia diagnostic imaging |
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| 中文摘要: |
| 目的 探讨MRI、CT、超声、核素显像术前定位诊断继发性甲状旁腺功能亢进症（SHPT）增生结节的价值。方法 回顾性分析48例因尿毒症SHPT接受甲状旁腺手术治疗患者，术前均接受颈部和上纵隔区MR检查；41例接受平扫和增强CT，39例接受核素检查，范围同MRI；36例接受颈部超声。分析左右2对甲状旁腺及左、右上纵隔共6个区，以病理结果为金标准，比较各种方法术前诊断甲状旁腺各分区增生结节的效果。结果 48例中，共156个分区存在156枚甲状旁腺增生结节。术前MRI、CT增强、超声、核素显像诊断左右2对甲状旁腺SHPT增生结节的敏感度分别为88.64%、82.91%、49.06%及64.91%，特异度分别为78.33%和91.49%和89.47%和76.19%。MRI联合增强CT、MRI联合核素的诊断敏感度、特异度分别为93.16%、72.34%和96.49%、30.95%。术前MRI联合增强CT诊断上纵隔异位增生结节的敏感度和特异度分别为78.95%和80.95%。结论 MRI、CT、超声及核素显像术前定位诊断SHPT增生结节各具优势，联合应用有利于提高诊断敏感度。 |
| 英文摘要: |
| Objective To investigate the value of MRI, CT, ultrasound and nuclide imaging in preoperative diagnosis of secondary hyperparathyroidism (SHPT) hyperplastic nodules. Methods Data of 48 uremia SHPT patients who underwent parathyroid resection were retrospectively analyzed. Before operation, all patients received MR examination, 41 received plain and enhanced CT scanning, 39 received radionuclide examination of neck and upper mediastinum, while 36 patients received ultrasound examination of neck. Two pairs of left and right parathyroid glands and left and right upper mediastinum were observed. Taken pathological results as the gold standards, the effects of various imaging methods in preoperative diagnosis of hyperplastic nodules in various parathyroid regions were calculated and compared. Results Totally 156 parathyroid hyperplastic nodules were found in 156 regions among 48 patients. The sensitivity of MRI, enhanced CT, ultrasonography and radionuclide imaging in diagnosis of SHPT hyperplasia nodules in two pairs of left and right parathyroid glands was 88.64%, 82.91%, 49.06% and 64.91%, and the specificity was 78.33%, 91.49%, 89.47% and 76.19%,respectively. The sensitivity and specificity of MRI combined with enhanced CT was 93.16% and 72.34%, of MRI combined with radionuclide imaging was 96.49% and 30.95%, respectively. The sensitivity and specificity of MRI combined with enhanced CT in diagnosis of SHPT hyperplasia nodules in the upper mediastinum was 78.95% and 80.95%, respectively. Conclusion Each of MRI, CT, ultrasonography and radionuclide imaging had curtain advantages in preoperative diagnosis of SHPT hyperplasia nodules. Combining application could improve diagnostic sensitivity. |
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