原发性甲状旁腺机能亢进性骨病CT、MRI与病理对照的实验研究  

Experimental study of osteopathy in primary hyperparathyroidism:CT, MRI and histopathology

作　　者：白荣杰[1] 柳淑云[2] 刘若鹏[3] 申宝忠[1] 姜慧杰[4] 韩铭钧[4] 吴振华[5] 

机构地区：[1]哈尔滨医科大学附属第四医院放射科,黑龙江哈尔滨150001 [2]大庆市第四医院心内科,黑龙江大庆163712 [3]大庆市第四医院放射科,黑龙江大庆163712 [4]中国医科大学附属第一医院放射科,辽宁沈阳110001 [5]中国医科大学附属第二医院放射科,辽宁沈阳110004

出　　处：《中国医学影像技术》2005年第12期1881-1884,共4页Chinese Journal of Medical Imaging Technology

摘　　要：目的研究原发性甲状旁腺机能亢进(PHPT)骨骼病变的CT、MRI特征性表现及诊断价值。方法健康成年中国白兔80只,随机分成两组,对照组40只以正常饮食(Ca∶P,1∶0.7)喂养,实验组40只以高磷饮食(Ca∶P,1∶7)喂养诱发原发性甲状旁腺机能亢进动物模型。在第3、4、5、6个月,分别对实验组和对照组动物行高场MR及螺旋CT骨扫描分析影像学特征。同时对所有动物甲状旁腺及骨标本行病理学检查,评价影像诊断的准确性。结果送检的甲状旁腺明显增生。骨骼均存在骨质疏松和骨皮质吸收的表现,MRT1WI表现不同程度局限性低信号改变,T2WI早期表现为不同程度的局限性低信号或中等信号改变,如骨髓水肿表现为高信号改变,随病情进展纤维组织取代骨组织则为低信号改变。相应螺旋CT扫描依次为阴性,可疑,骨质疏松,骨膜下皮质吸收表现。而对照组动物甲状旁腺及骨骼均未见异常。结论高场MR结合螺旋CT扫描既可发现早期病变又可进行分期,是研究早期PHPT骨骼病变的可靠手段。Objective To study the characteristics of osteopathy in primary hyperparathyroidism （PHPT） on CT, MRI and histopathology. Methods Eighty adult rabbits were randomly divided into two groups with forty in each group. The control group was fed with normal diet （Ca ： P, 1 ： 0. 7）, while the experimental group was fed with high phosphate diet （Ca ： P, 1 ： 7） for 3, 4, 5, or 6 months intervals to establish the animal model of PHPT. The staging and imaging findings of the early PHPT were determined by high-field MRI and spiral CT （SCT） scan at the 3rd, 4th, 5th and 6th month. All the rabbits were sacrificed after high-field MRI and SCT scan, and the parathyroid and bone were removed together for pathological examination, which were performed for evaluating the accuracy of imaging diagnosis. Results Parathyroid histopathologic studies demonstrated hyperplasia, and the osteoporosis and early cortical bone resorption were revealed of the bone. The osteopathy in PHPT displayed different degrees of low signal intensity on TIWI and low to intermediate signal intensity on T2WI of the early stage in bone. The high signal intensity were displayed for medullar edema on T2WI, and high signal intensity which turned into low signal intensity on T2WI with the development of disease and disappearance of medullar ede- ma, but showed correspondingly negative, suspicions, osteoporosis and subperiosteal cortical resorption of the bone on SCT scan, while the control group showed no abnormal changes in the parathyroid and bone. Conclusion High-field MRI combining with SCT scan, which could not only exactly display the early osteopathy in PHPT but also perform staging, might be a reliable method for the study of early osteopathy in PHPT.

关 键 词：原发性甲状旁腺机能亢进 骨病 磁共振成像 体层摄影术 X线计算机 

分 类 号：R582[医药卫生—内分泌] R814.42[医药卫生—内科学]