原发性甲旁亢的影像学诊断

目的：对原发性甲旁亢的影像学检查方法及诊断价值进行评估。材料和方法：对手术病理证实的５３例原发性甲旁亢病例的影像学资料进行回顾性分析。其中３５例作ＣＴ检查，Ｂ超检查４６例，核素检查５例。结果：５３例甲旁亢手术确诊甲旁腺腺瘤５１例，占９６．２３％。甲旁腺增生２例。ＣＴ检查有２７例诊断为甲旁腺腺瘤（２７／３５），病灶８１．４８％位于甲状腺下极（２２／２７），１８．５２％位于甲状腺上极（５／２７）；各病灶增强后通常有明显强化，比平扫时ＣＴ值上升约３０￣４０Ｈｕ。Ｂ超检查有３８例诊断为甲旁腺腺瘤（３８／４６）。核素检查中３例误诊为甲状腺腺瘤。结论：原发性甲旁亢的定性诊断主要依靠临床及生化检查，定位诊断依靠Ｂ超、ＣＴ及核素等影像学检查，Ｂ超和ＣＴ检查的原发笥甲旁亢的诊断中敏感性及特异性无显著差别，两者可互相补充，根据甲旁

Imaging Diagnosis of Primary Hyperparathyroidism

Purpose: To evaluate the imaging examination and diagnostic value of primary byperparathyroidism (PH). Materials and Methods: The imaging characteristics and the diagnostic values of multiple modalities (CT , US, ECT) in PH were analyzed respectively. Among 53 cases of PH proved by surgico- pathology, CT scan was performed in 35; B mode ultrasound, in 46; and nuclein examination, in 5. Re- suits: 96. 23% (51 of 53 PH) parathyroid adenomas and 3. 77% (2 of 53 PH)Parathyroid hyperplasia were confirmed in this group. Twenty - seven cases performed by CT and 38 cases examined by B ultrasound were totally found before operation. 81. 48% (22 of 27 adenomas) lay in lower pole of throid glands and 18. 52% (5 of 27) lay in upper pole. The CT acquisition of lesions was significantly increased after contrast - enhanced scans. Conclusion: To establish the diagnosis of PH mainly depends on clinical history and lab examination. To locate the lesion of PH mainly depends on B ultrasound, CT scan and nuclein scintigraphy. There are no significant differences in sensitivity and specificity between B ultrasound and CT scan. With the CT characters of obvious enhancement of parathyroid lesion and the clinical features, the diagnostic accuracy of PH can be improved.