CT和MRI在原发性甲状旁腺功能亢进中的应用价值  

Value of CT and MRI in Patients with Primary Hyperparathyroidism

作　　者：潘玉萍[1] 庄奇新[1] 沈艳[1] 杨世埙[1] 李明华[1] 

机构地区：[1]上海交通大学附属第六人民医院放射科,上海200233

出　　处：《放射学实践》2006年第5期487-490,共4页Radiologic Practice

摘　　要：目的:探讨CT和MRI对原发性甲状旁腺功能亢进患者的诊断价值。方法:30例经手术病理证实的甲状旁腺占位性病变患者,临床上均有骨骼肌肉酸痛症状,27例有骨质疏松或伴有其它骨骼异常的X线表现,其中病理性骨折3例、骨骼畸形2例、局部骨骼有溶骨性或纤维囊性改变5例(病理证实为棕色瘤),11例合并泌尿系结石。术前行CT(28例)和MRI(7例)检查。结果:30例均为甲状旁腺单发病灶,腺瘤26例、腺癌3例、增生1例。24例病灶位于颈长肌前甲状腺中后部或下极附近的气管-食管旁沟内;异位者6例,分别位于颈根部胸骨柄后、颈动脉鞘、甲状腺内、右前上纵隔和气管后胸廓入口处。28例行CT检查者,术前检出病灶25个(25/28),未检出的病灶3个。7例行MRI检查,术前病灶均被检出。结论:临床上高度怀疑原发性甲旁亢患者颈部的CT和MRI检查是必要的,CT和MRI不仅能有效检出甲状旁腺肿瘤,并对其作出定位和定性诊断,为手术治疗提供可靠依据。Objective：To study the value of CT and MRI in patients with clinical symptoms of primary hyperparathyroidism （PHPT）. Methods：Thirty patients with parathyroid mass were examined before surgery by CT scan （n= 28） and MRI （n=7）. All the patients had clinical symptoms such as muscle and bone pain. 27 patients had osteoporosis and/or other skeletal abnormalities detected by X-ray examination, including pathologic fracture （n=3）, skeletal deformities （ n =2 ）, osteolytic or fibrocystic lesion of bone （n=5, pathology proved as brown tumor）. There were 11 patients had urolithiasis. Results..All of the 30 cases had solitary parathyroid mass,including adenoma （n=26） ,carcinoma （n=3） and 1 case of parathyroid hypertrophy. 24 masses were located in the middle-posterior region of thyroid gland,in front of musculi longus colli,or adjacent to the lower pole of thyroid gland within tracheo-esophageal groove, 6 masses were ectopic,which was located at the area behind the manubrium sterni, within carotid sheath, intra-thyroid gland, the right side of anterior mediastinum and thoracic inlet posterior to the trachea respectively. For the 28 cases having CT scan,accurate diagnosis were obtained in 25 cases （25/28）. Lesions were detected in all of the 7 cases having MRI （7/7）. Conclusion： For patients having symptoms or clinically highly suspicious of PHPT, CT and/or MRI of neck are very helpful in the detection and diagnosis of primary parathyroid neoplasm as well as precise tumor localization,providing reliable information for surgical planning.

关 键 词：甲状旁腺功能亢进症 颈部 体层摄影术 X线计算机 磁共振成像 

分 类 号：R445[医药卫生—影像医学与核医学]