甲状旁腺癌的影像学表现(附6例报道并文献复习)

Imaging manifestations of parathyroid carcinoma(6 cases and literature review)

目的:探讨甲状旁腺癌的影像学表现。方法:回顾性分析经手术病理证实的6例甲状旁腺癌患者超声、^(99m )Tc-MIBI双时相显像SPECT/CT(或SPECT)、MRI、^(18)F-FDG PET/CT显像资料,并结合文献对照分析。结果:超声表现:原发病灶平均最大直径为27.7 mm;6例均为低回声,其中4例内部回声不均匀,2例伴有钙化影及液化影;3例边界不清,3例边界尚清;4例病灶边缘及内部见点状及条状血流,2例病灶内见血流丰富。^(99m)Tc-MIBI双时相显像:3例阳性,3例阴性;4例行SPECT/CT检查的患者中分析同机融合CT平扫表现,2例边界不清,2例边界尚清,4例均呈低密度影,其中2例伴有钙化影。1例行颈部软组织MRI检查,表现为甲状腺左叶中上部后缘结节,边界清楚,T_1WI呈稍低信号,T_2WI呈稍高信号,压脂像呈高信号。1例术后行^(18)F-FDG PET/CT显像示全身多发骨骼^(18)F-FDG不同程度增高,SUVmax为2.5~8.8,CT示部分骨骼骨质破坏伴软组织肿块形成。结论:甲状旁腺癌的影像表现具有一定的特点,密度不均匀,内伴有钙化影,边界不清有助于甲状旁腺癌的诊断;MRI能显示病变部位及病灶毗邻关系;^(18)F-FDG PET/CT显像对肿瘤分期、术后评估及随访有帮助。

Objective： To study the imaging manifestations of parathyroid carcinoma. Methods： Ultrasonography,99 mTc-MIBI SPECT/CT（or SPECT）, MRI findings and18 F-FDG PET/CT of 6 patients with parathyroid carcinoma confirmed pathologically were analyzed retrospectively, and reviewing relevant literatures. Results： Ultrasonography findings： The average maximum diameter of 6 lesions was 27.7 mm; 6 cases manifested hypoechonic, 2 of which had mirocalcifications; 3 cases showed sharp in grey scale while 3 cases presented blurred nodular margin; 4 cases had a little blood flow while 2 cases with rich blood flow.99 mTc-MIBI SPECT/CT（or SPECT） findings： 3 cases were positive and 3 cases were negative; On CT imaging, 2 cases contained microcalcifications. On MRI, 1 case showed slight low signals on T1 WI and slight hyperintensity signals on T2 WI, and hyperintensity signal on T1-weighted sequence. One case of postoperative18 F-FDG PET/CT found intensely high FDG uptake in multiple bones（range of SUVmax： 2.5~8.8） with osteolytic destruction and soft tissue mass. Conclusion： The imaging findings of parathyroid carcinomas have certain features. Heterogeneous intensity, microcalcifications, blurred nodular marginare helpful for diagnosis of parathyroid carcinoma. MRI can clearly manifest the relationship between adjacent tissues.18 F-FDG PET/CT is contributed to restaging, evaluation of postsurgery and follow-up of parathyroid carcinoma.