摘要
目的探讨甲状旁腺CT三维重建对难治性继发性甲状旁腺功能亢进症(secondary hyperparathyroidism,SHPT)的诊断意义。方法选取2016年1月~2019年1月期间医院放射科收治的62例难治性SHPT为研究对象,术前均行CT三维重建检查和B超检查。观察CT三维重建和B超图像表现,以病理检查为"金标准",分析CT三维重建和B超诊断难治性SHPT的价值。结果 62例患者中,手术切除甲状旁腺增大208枚,另手术切除甲状旁腺30枚,经病理检查为正常甲状旁腺组织;CT三维重建病灶呈长圆形、椭圆形、不规则形或分叶状,大多数密度不均一,伴有点状钙化或环形钙化;B超检查病灶形态呈长圆形、椭圆形、不规则形或分叶状,包膜完整,大多数结节呈低回声,其中伴有条带样回声,或表现为液性暗区。CT三维重建诊断SHPT灵敏度、特异度分别为0.798和0.600,超声诊断SHPT灵敏度、特异度分别为0.663和0.667。结论相对于B超检查,甲状旁腺CT三维重建可明显提高SHPT诊断灵敏度,是术前增生甲状旁腺定位、SHPT诊断的有效方法。
Objective To explore the diagnostic significance of CT threedimensional reconstruction of parathyroid gland in patients with refractory secondary hyperparathyroidism(SHPT). Methods 62 patients with refractory SHPT who were treated in radiology department of the hospital from January 2016 to January 2019 were selected for the study. All patients were given CT three-dimensional reconstruction and B-ultrasound before surgery. The image findings of CT three-dimensional reconstruction and B-ultrasound were observed, and the pathological examination was taken as the gold standard to analyze the value of CT three-dimensional reconstruction and B-ultrasound in the diagnosis of refractory SHPT. Results Among the 62 patients, 208 parathyroid enlargements were removed by surgery, and 30 parathyroid glands were removed by surgery, and they were diagnosed as normal parathyroid tissues by pathological examination. CT three-dimensional reconstruction showed obround, oblong, irregular or lobulated lesions most with density inhomogeneity, punctate calcification or annular calcification. B-ultrasound examination showed obround, oblong, irregular or lobulated lesions with intact capsule, and most hypoechoic nodules with strip-like echo or fluid sonolucent area. The sensitivity and specificity of CT three-dimensional reconstruction were 0.798 and 0.600 respectively in the diagnosis of SHPT, and the sensitivity and specificity of ultrasound were 0.663 and 0.667 respectively in the diagnosis of SHPT. Conclusion Compared with B-ultrasound examination, CT three-dimensional reconstruction of parathyroid gland can significantly improve the sensitivity of SHPT diagnosis. It is an effective method for preoperative parathyroid hyperplasia positioning and SHPT diagnosis.
作者
易建玮
林冬梅
吴荣兴
陈水奕
YI Jian-wei;LIN Dong-mei;WU Rong-xing(Department of Radiology,Liuzhou Iron and Steel Group Company Hospital,Liuzhou 545002,Guangxi Province,China)
出处
《中国CT和MRI杂志》
2020年第7期33-35,共3页
Chinese Journal of CT and MRI
基金
广西壮族自治区卫生健康委员会自筹经费科研项目。
关键词
CT三维重建
B超
难治性
继发性甲状旁腺功能亢进症
诊断价值
CT Three-dimensional Reconstruction
B-ultrasound
Refractory
Secondary Hyperparathyroidism
Diagnostic Value
