甲状旁腺肿瘤致原发性甲状旁腺机能亢进的影像学诊断  

Diagnostic Imaging of Primary Hyperparathyroidism Caused by Parathyroid Tumor

作　　者：蔡世峰[1] 邵长清[1] 代守平 盖永浩[1] 薛燕[1] 徐云[1] 马骏 李俊来[3] 

机构地区：[1]山东省临沂市人民医院,276003 [2]山东省医学影像学研究所 [3]解放军总医院论著

出　　处：《医学影像学杂志》1999年第2期86-88,共3页Journal of Medical Imaging

摘　　要：目的总结８例甲状旁腺肿瘤及并发症的影像学特征。材料与方法全组病例术前局部及肾区均行Ｂ超检查和骨骼Ｘ线摄片检查。术前局部彩超、ＣＴ平扫各５例，ＣＴ强化４例。结果腺癌７例，６例位于甲状腺下极。Ｂ超示边界清楚，包膜完整的低回声结节。２例瘤体内可见无回声区，其中１例有点状钙化；彩超检查瘤体内与外周均见丰富血流信号，并见动脉血流进入瘤体内；ＣＴ平扫为边界清楚的低密度灶，具均匀强化。腺癌１例，Ｂ超和ＣＴ均示形态不规则，有点状钙化的低回声或低密度肿块，彩超无血流信号；ＣＴ可清楚显示其浸润情况。骨骼改变、肾结石各５例，肾钙质沉着症２例。结论（１）影像检查的联合应用，对肿瘤的定位、定性较可靠，（２）以肾脏病变为主要表现时易误诊．应及时检查甲状旁腺。Purpose To sumarize imaging features of parathyroid tumor and its complications. Materials and methods All the patients in this group were examined by tumor and kidney ultrasonography and bone x-ray film before operation, and 5 of them received colour Doppler flowing image (CDFI)and CT examination of the parathyroid gland. Results There were 7 cases of parathyroid adenoma, 6 of them were located at the lower pole of the thyroid gland. Ultrasonography showed low-echo nodes with sharp margin and integrated membrane. Echoless areas were found in 2 nodes and calcification in 1 node. Rich blood flow signals were detected within and around the tumors by CDFI,arterial blood were seen flowing into the tumors. Hypodense nodes with clear margin shown by CT were homogeneously enhanced. In the one case of parathyroid carcinoma,both parathyroid ultrasonography and CT showed irregular low-echo or hypodense mass with calcification in it,CDFI showed no blood flow signal. Invasion of the neighbouring stuctures of the cancer was also clearly shown by CT examination. Either abnormality of the bone or kidney stones were found in five cases. There were 2 cases of renal calcinosis. Conclusion (1)Combination of different imaging methods results in reliable localization and qualification of parathyroid tumor. (2)It is liable to misdiagnosis when parathyroid tumor is mainly manifested by abnormality of the kidney. Examinations of the parathyroid gland are need under such conditions.

关 键 词：甲状旁腺肿瘤 甲旁亢 诊断 影像学诊断 

分 类 号：R736.206[医药卫生—肿瘤] R582.104[医药卫生—临床医学]