多种影像学方法术前诊断继发性甲状旁腺功能亢进症增生结节

目的 探讨MRI、CT、超声、核素显像术前定位诊断继发性甲状旁腺功能亢进症(SHPT)增生结节的价值.方法 回顾性分析48例因尿毒症SHPT接受甲状旁腺手术治疗患者,术前均接受颈部和上纵隔区MR检查;41例接受平扫和增强CT,39例接受核素检查,范围同MRI;36例接受颈部超声.分析左右2对甲状旁腺及左、右上纵隔共6个...

Multiple imaging methods in preoperative diagnosis of hyperplastic nodules in secondary hyperparathyroidism

Objective To investigate the value of MRI, CT, ultrasound and nuclide imaging in preoperative diagnosis of secondary hyperparathyroidism (SHPT) hyperplastic nodules. Methods Data of 48 uremia SHPT patients who underwent parathyroid resection were retrospectively analyzed. Before operation, all patients received MR examination, 41 received plain and enhanced CT scanning, 39 received radionuclide examination of neck and upper mediastinum, while 36 patients received ultrasound examination of neck. Two pairs of left and right parathyroid glands and left and right upper mediastinum were observed. Taken pathological results as the gold standards, the effects of various imaging methods in preoperative diagnosis of hyperplastic nodules in various parathyroid regions were calculated and compared. Results Totally 156 parathyroid hyperplastic nodules were found in 156 regions among 48 patients. The sensitivity of MRI, enhanced CT, ultrasonography and radionuclide imaging in diagnosis of SHPT hyperplasia nodules in two pairs of left and right parathyroid glands was 88.64%, 82.91%, 49.06% and 64.91%, and the specificity was 78.33%, 91.49%, 89.47% and 76.19%,respectively. The sensitivity and specificity of MRI combined with enhanced CT was 93.16% and 72.34%, of MRI combined with radionuclide imaging was 96.49% and 30.95%, respectively. The sensitivity and specificity of MRI combined with enhanced CT in diagnosis of SHPT hyperplasia nodules in the upper mediastinum was 78.95% and 80.95%, respectively. Conclusion Each of MRI, CT, ultrasonography and radionuclide imaging had curtain advantages in preoperative diagnosis of SHPT hyperplasia nodules. Combining application could improve diagnostic sensitivity.