甲旁亢与骨软化症的骨显像对比分析  

Comparative analysis of bone imaging features of primary hyperparathyroidism and osteomalacia

作　　者：张连娜[1] 杨芳[1] 冯瑾[1] 

机构地区：[1]北京积水潭医院核医学科,北京100035

出　　处：《中国临床医学影像杂志》2015年第9期663-666,共4页Journal of China Clinic Medical Imaging

摘　　要：目的:研究原发性甲状旁腺功能亢进(PHPT)及骨软化症(OM)患者的核素全身骨显像表现特征,对比骨显像在诊断和鉴别诊断这两种疾病中的应用价值。方法:回顾性分析经病理或临床随访证实64例PHPT患者及24例OM患者的全身骨显像表现特征,比较两种疾病在影像表现及实验室检查方面的差异。结果:黑颅、下颌骨浓集、四肢骨皮质普遍摄取增高为PHPT组骨显像的特征性表现,而如果骨显像表现为肋骨点状浓集、脊柱条状浓集,全身大关节尤其是承重关节放射性浓集则更应考虑为骨软化。两组生化指标比较显示两组患者的血清碱性磷酸酶、钙及甲状旁腺激素水平的差异有统计学意义(P<0.05)。结论 :全身骨显像可作为PHPT及OM的一种重要的影像手段,能更灵敏、全面地探测棕色瘤及假骨折部位,结合患者的影像特征及相关实验室检查指标有助于这两种疾病的鉴别。Objective： To study the imaging feature of primary hyperparathyroidism （PHPT） and osteomalacia （OM） on ra- dionuclide bone scan and investigate the value of bone scan in the diagnosis and differential diagnosis. Methods： The whole- body bone scan findings of 46 primary hyperparathyroidism patients and 24 osteomalacia patients who had been proven by pathology or clinical followed-up were retrospectively analyzed. The differences between the two groups in imaging manifesta- tion and laboratory examination were compared. Results： The bone scintigraphy features of hyperparathyroidism were ＂black skull＂, mandible, limb bone cortex concentration generally increased uptake, and if the bone imaging showed rib punctate concentration, spine strip concentration, large joint body especially weight-bearing joint radioactive concentration should be more consideration for osteomalacia. The differences of serum alkaline phosphatase, calcium and parathyroid hormone levels be- tween the two groups were statistically significant （P〈0.05）. Conclusion： Whole body bone imaging can be used as an important imaging method for PHPT and OM, and may be more sensitive and comprehensive to detect brown tumor and false fracture site. Combined with the imaging features and the related laboratory tests, it is helpful to differential diagnosis the two diseases.

关 键 词：甲状旁腺功能亢进症 骨软化症 放射性核素显像 

分 类 号：R582.1[医药卫生—内分泌] R591.44[医药卫生—内科学]