4D-DECT对甲状旁腺腺瘤的诊断价值

目的:探讨甲状旁腺腺瘤（PA）的4D-DECT影像特征及物质成分信息，评价其定位及定性诊断价值。资料和方法:回顾性分析经手术及病理证实的53例PA患者的临床资料及4D-DECT影像资料，逐一观察并记录CT征象，分别对病变与邻近组织的CT衰减值（HU）、碘浓度、Rho、Z值及DEI进行测定及比较分析。结果:53例患者中，52例（98.11%）为单发病灶，1例（1.89%）为多发病灶，共计病灶54枚，其中32枚（59.26%）位于气管-食管旁沟，10枚（18.52%）为异位腺瘤，22枚（40.74%）可见“短线征”，14枚（25.93%）可见“极血管征”；动脉期（90 kV）图像PA与甲状腺CT值无明显差异，平扫、动脉期（混合0.5、150 kV）及静脉期（90 kV、混合0.5、150 kV）图像中PA、甲状腺及淋巴结CT值均有差异。动脉期及静脉期淋巴结的碘浓度、Z值及DEI明显低于PA及甲状腺，静脉期PA的碘浓度、Z值及DEI明显低于甲状腺；动脉期及静脉期甲状腺Rho明显高于PA，动脉期PA的Rho明显高于淋巴结。结论:4D-DECT可较好地显示PA的影像学特征，还可以提供病变的碘浓度等多种物质成分信息，有助于提高PA的诊断准确性。 

The Value of Four-dimensional Dual Energy CT on Diagnosis of Parathyroid Adenoma

Objective: To investigate the imaging characteristics and material tissue characteristics of parathyroid adenoma(PA) with four-dimensional dual energy computed tomography(4D-DECT), and to evaluate the value of localization and qualitative diagnosis. Materials and methods: the clinical and 4D-DECT imaging data of 53 patients with PA confirmed by operation and pathology were retrospectively analyzed. The CT signs were observed and recorded, and CT value, iodine concentration, Rho, Z value and DEI were measured and analyzed. Results: In 53 patients, 52(98.11%) cases of PA were solitary, 1(1.89%) case with multiple nodules, a total of 54 lesions were found, 32(59.26%) of which were located in the trachea-esophageal sulcus, 10(18.52%) lesions were ectopic adenomas, and 22(40.74%) lesions showed "short line sign", 14(25.93%) showed "polar vessel sign"; there was no significant difference in CT value between PA and thyroid in arterial phase(90 kV), but the CT value of PA, thyroid and lymph nodes were different in non-contrast, arterial phase(M 0.5, 150 kV) and venous phase(90 kV, M 0.5, 150 kV). Iodine concentration, Z value and DEI of lymph nodes in arterial and venous phase were significantly lower than those of PA and thyroid, iodine concentration, Z value and DEI of PA in venous phase were significantly lower than those of thyroid; Rho of thyroid in arterial and venous phase was significantly higher than that of PA, and Rho of PA in arterial phase was significantly higher than that of lymph nodes. Conclusion: 4D-DECT can better display the imaging features of PA, and can also provide the analysis of iodine concentration and a variety of material tissue characteristics information, which is helpful to improve the diagnostic accuracy of PA.