摘要
目的分析慢性肾功能衰竭继发性甲状旁腺功能亢进颈部动态增强CT表现并探讨CT术前定位的诊断价值。方法回顾性分析2011年7月至2013年2月本院血液净化中心甲状旁腺功能亢进的23例慢性肾功能衰竭的透析患者颈部动态增强CT的影像资料,并与手术结果对照。结果 23例患者共发现84个病灶,病灶多为椭圆形,最大横截面为0.6 cm×0.4 cm^1.9 cm×1.7 cm。其中20例患者病灶密度均匀,平扫CT值约21~48 HU,增强后病灶均匀强化,每例患者强化程度不一,第1期明显强化,CT值约41~115 HU,第2期进一步强化,CT值约65~121 HU,第3期强化减退,CT值约23~81 HU,各期CT值均低于相对应甲状腺的CT值;3例患者病灶密度不均,其内见数量不等的斑点状钙化,不均匀强化。上组病灶大部位于甲状腺后方,部分下组病灶位于甲状腺下方。手术中共发现病灶87个,CT定位准确性为96.6%。12例患者扫描所及骨质有不同程度破坏。结论颈部动态增强CT能准确定位继发性甲状旁腺增生或/和腺瘤,通过各种CT后处理方法能够清楚显示病灶特点、与周围结构的关系。
Objective To analyze the neck dynamic enhanced CT features of secondary hyperparathyroidism and inves- tigate its value for preoperative location. Methods Retrospective analysis of the dynamic enhanced CT image data of 23 dialysis patients with chronic renal failure were taken, all patients were admitted to the hemodialysis center because of secondary hyperparathyroidism from February 2013 to July 2011, and the CT results were compared with surgical findings. Results 84 lesions were diagnosed in 23 patients and most of them were oval, with size from 0.6 ×0. 4 to 1.9 × 1.7 cm. There were 20 lesions with homogeneous density and variable enhancement. CT value of the first, second and last phase were 41 - 115 HU, 65 - 121 HU and 23 - 81 HU, respectively. 3 cases had heterogeneous density and variable calcification. The superior group lesions located behind the thyroid and parts of the inferior lesions located below the thyroid. The accuracy of CT for preoperative location was 96.6%. There were variable bone destruction in 12 patients. Conclusion The secondary parathyroid hyperplasia or adenoma can be accurately located and diagnosed with neck dynamic enhanced CT.
出处
《临床放射学杂志》
CSCD
北大核心
2013年第9期1247-1250,共4页
Journal of Clinical Radiology
