| 柳少杰,潘梦洁,符孔,方海勇.甲状旁腺切除术后尿毒症肿瘤样钙化症伴继发性甲状旁腺功能亢进症临床及影像学改变[J].中国医学影像技术,2025,41(12):2037~2040 |
| 甲状旁腺切除术后尿毒症肿瘤样钙化症伴继发性甲状旁腺功能亢进症临床及影像学改变 |
| Clinical and imaging changes of uremic tumoral calcinosis complicated with secondary hyperparathyroidism after parathyroidectomy |
| 投稿时间：2025-05-19 修订日期：2025-11-08 |
| DOI：10.13929/j.issn.1003-3289.2025.12.021 |
| 中文关键词: 尿毒症 钙质沉着症 甲状旁腺功能亢进症,继发性 甲状旁腺切除术 诊断显像 |
| 英文关键词:uremia calcinosis hyperparathyroidism, secondary parathyroidectomy diagnostic imaging |
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| 中文摘要: |
| 目的 观察甲状旁腺切除术(PTX)后尿毒症肿瘤样钙化症(UTC)伴继发性甲状旁腺功能亢进症(SHPT)临床及影像学改变。方法 回顾性分析13例接受PTX的UTC伴SHPT患者,观察其PTX前、后临床及影像学(X线、CT及MRI)表现。结果 PTX前,13例均见血磷及全段甲状旁腺激素(iPTH)升高;1例血钙升高、12例血钙正常。13例中,7例为单发、6例为多部位多发UTC;9例病灶位于关节周围,包括单关节周围5例、多关节周围4例。影像学显示13例UTC均为软组织结节状/囊状高密度灶,可见"卵石样"及"流注状"钙化;其中6例囊状病灶伴"沉降征",3例累及邻近骨骼。PTX后随访3~60个月,13例血磷及iPTH均明显降低,12例UTC病灶部分或完全吸收、1例无明显变化。结论 PTX后UTC伴SHPT患者血磷及iPTH明显降低,UTC病灶部分或完全吸收。 |
| 英文摘要: |
| Objective To observe the clinical and imaging changes of uremic tumoral calcinosis (UTC) complicated with secondary hyperparathyroidism (SHPT) after parathyroidectomy (PTX). Methods Thirteen patients with UTC complicated with SHPT who underwent PTX were retrospectively enrolled. The clinical and imaging (X-ray, CT and MRI) manifestations before and after PTX were comparatively observed. Results Before PTX, increased serum phosphorus and intact parathyroid hormone (iPTH) were noticed in all 13 cases, while increased serum calcium was found in 1 case and normal serum calcium was observed in 12 cases. Among 13 cases of UTC, single lesion was detected in 7 cases, while multiple lesions in multiple locations were detected in 6 cases, and lesions located around the joints in 9 cases, including single joint in 5 cases and multiple joints in 4 cases. Imaging examinations showed that all 13 cases of UTC presented as soft tissue nodular/cystic high-density lesions, with "pebble like" and "flow like" calcifications. Among 13 cases, "subsidence sign" was found in 6 cases with cystic lesions, and adjacent bone invasion was noticed in 3 cases. During 3—60 months’ follow-up after PTX, significantly decreased serum phosphorus and iPTH were observed in all 13 cases, with partial or complete absorption of UTC lesions in 12 cases but no significant change in 1 case. Conclusion After PTX, serum phosphorus and iPTH decreased significantly in patients with UTC complicated with SHPT, often with partial or complete absorption of UTC lesions. |
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