MRI在血透患者继发性甲状旁腺功能亢进术前定位诊断中的价值

Preoperative Localization Role of MRI in Secondary Hyperparathyroidism Patients on Maintenance Hemodialysis

目的评价高场强磁共振成像(magnetic resonance imaging,MRI)对维持性血液透析(maintenance hemodialysis,MHD)患者继发甲状旁腺功能亢进(secondary hyperparathyroidism,SHPT)时,术前对病变甲状旁腺的定位诊断价值。方法 MHD并不同程度甲状旁腺激素水平增高的患者11例,在病变甲状旁腺切除术前行高场强3.0T MRI检查。结果 11例患者经病理证实共有31枚增生甲状旁腺,术前MRI检出26枚,检出率达83.9%。其中T2WI压脂序列上病灶的异常高信号与周围组织对比明显,易于发现病灶;而T1WI序列上多个病灶之间或病灶与甲状腺之间的解剖分辨率好,多序列、多方位结合诊断准确率高。结论高场强MRI检查对于SHPT患者多发甲状旁腺增生具有良好的组织分辨率和较高的术前定位诊断准确率,不失为一种有效的检查方法。

Objective To investigate the role of preoperative localization of high field magnetic resonance imaging （MRI） in secondary hyperparathyroidism （SHPT） patients on maintenance hemodialysis （MHD）. Methods 3. 0T high field MRI was performed in 11 MHD patients who presented with SHPT and would undergo parathyroidectomy. Results Thirty-one hyper- plastic parathyroid glands were pathologically confirmed in 11 patients. Among the glands, 26 were successfully identified by MRI before operation with the accuracy rate being 83.9 %. Hyperplastic parathyroids were easy to locate by fat-saturated T2- weighted imaging with improved contrast resolution. Furthermore,Tl-weighted imaging showed higher anatomical resolution among multiple lesions,or between the lesion and the thyroid. Conclusion 3.0T high field MRI of high contrast resolution helps localize hyperplastic parathyroid glands in patients subject to MHD. It is an effective imaging method for SHPT diagnosis.