-
甲状旁腺常位于甲状腺的背侧,当其机能亢进时,会表现为血磷水平降低而血钙水平增高,骨的钙盐被过分吸收,导致骨质疏松及钙盐沉积于其他器官。原发性甲状旁腺功能亢进症(primary hyperparathyroidism,PHPT)多由单个甲状旁腺腺瘤引起,其诊断基于生化检测,表现为血钙水平升高、甲状旁腺激素(parathyroid hormone,PTH)水平正常或升高,伴不同程度的骨质疏松症和病理性骨折、肾功能不全等[1]。治疗PHPT的主要手段是手术切除功能亢进的甲状旁腺组织,精准切除病灶后,可有效缓解上述症状。但由于甲状旁腺与甲状腺及胸腺的位置很近,而且有血管、淋巴管和神经穿行进入,因此手术的成败及术后复发率取决于术前病灶的精确定位[2],目前临床中常见的PHPT患者多以甲状旁腺腺瘤为主,笔者将以甲状旁腺腺瘤为主要研究对象进行综述。
HTML
[1] | Walker MD, Silverberg SJ. Primary hyperparathyroidism[J]. Nat Rev Endocrinol, 2018, 14(2): 115−125. DOI: 10.1038/nrendo.2017.104. | |
[2] | 李秀梅, 李军, 王宏桥, 等. 高频超声、超声造影与99mTc-MIBI SPECT/CT在难治性甲状旁腺功能亢进术前定位中的比较[J/OL]. 中华医学超声杂志(电子版), 2018, 15(7): 522−529[2023-01-29]. https://d.wanfangdata.com.cn/periodical/zhyxcszz201807010. DOI: 10.3877/cma.j.issn.1672-6448.2018.07.010. | Li XM, Li J, Wang HQ, et al. Localization value of ultrasonography, contrast-enhanced ultrasound and 99mTc-MIBI SPECT/CT in refractory secondary hyperparathyroidism[J/OL]. Chin J Med Ultrasound: Electron Ed, 2018, 15(7): 522−529[2023-01-29]. https://d.wanfangdata.com.cn/periodical/zhyxcszz201807010. DOI: 10.3877/cma.j.issn.1672-6448.2018.07.010. |
[3] | Ruda JM, Hollenbeak CS, Stack BC Jr. A systematic review of the diagnosis and treatment of primary hyperparathyroidism from 1995 to 2003[J]. Otolaryngol Head Neck Surg, 2005, 132(3): 359−372. DOI: 10.1016/j.otohns.2004.10.005. | |
[4] | Bossert I, Chytiris S, Hodolic M, et al. PETC/CT with 18F-Choline localizes hyperfunctioning parathyroid adenomas equally well in normocalcemic hyperparathyroidism as in overt hyperparathyroidism[J]. J Endocrinol Invest, 2019, 42(4): 419−426. DOI: 10.1007/s40618-018-0931-z. | |
[5] | Giovanella L, Bacigalupo L, Treglia G, et al. Will 18F-fluorocholine PET/CT replace other methods of preoperative parathyroid imaging?[J]. Endocrine, 2021, 71(2): 285−297. DOI: 10.1007/s12020-020-02487-y. | |
[6] | Reeder SB, Desser TS, Weigel RJ, et al. Sonography in primary hyperparathyroidism: review with emphasis on scanning technique[J]. J Ultrasound Med, 2002, 21(5): 553−554. DOI: 10.7863/jum.2002.21.5.539. | |
[7] | Batur A, Atmaca M, Yavuz A, et al. Ultrasound elastography for distinction between parathyroid adenomas and thyroid nodules[J]. J Ultrasound Med, 2016, 35(6): 1277−1282. DOI: 10.7863/ultra.15.07043. | |
[8] | Bleier BS, Livolsi VA, Chalian AA, et al. Technetium Tc 99m sestamibi sensitivity in oxyphil cell-dominant parathyroid adenomas[J]. Arch Otolaryngol Head Neck Surg, 2006, 132(7): 779−782. DOI: 10.1001/archotol.132.7.779. | |
[9] | Kuzminski SJ, Sosa JA, Hoang JK. Update in parathyroid imaging[J]. Magn Reson Imaging Clin N Am, 2018, 26(1): 151−166. DOI: 10.1016/j.mric.2017.08.009. | |
[10] | Carpentier A, Jeannotte S, Verreault J, et al. Preoperative localization of parathyroid lesions in hyperparathyroidism: relationship between technetium-99m-MIBI uptake and oxyphil cell content[J]. J Nucl Med, 1998, 39(8): 1441−1444. | |
[11] | Hoang JK, Williams K, Gaillard F, et al. Parathyroid 4D-CT: multi-institutional international survey of use and trends[J]. Otolaryngol Head Neck Surg, 2016, 155(6): 956−960. DOI: 10.1177/0194599816655311. | |
[12] | Liddy S, Worsley D, Torreggiani W, et al. Preoperative imaging in primary hyperparathyroidism: literature review and recommendations[J]. Can Assoc Radiol J, 2017, 68(1): 47−55. DOI: 10.1016/j.carj.2016.07.004. | |
[13] | Treglia G, Trimboli P, Huellner MW, et al. Imaging in primary hyperparathyroidism: focus on the evidence-based diagnostic performance of different methods[J]. Minerva Endocrinol, 2018, 43(2): 133−143. DOI: 10.23736/S0391-1977.17.02685-2. | |
[14] | Piccardo A, Bottoni G, Boccalatte LA, et al. Head-to-head comparison among 18F-choline PET/CT, 4D contrast-enhanced CT, and 18F-choline PET/4D contrast-enhanced CT in the detection of hyperfunctioning parathyroid glands: a systematic review and meta-analysis[J]. Endocrine, 2021, 74(2): 404−412. DOI: 10.1007/s12020-021-02798-8. | |
[15] | Boccalatte LA, Higuera F, Gómez NL, et al. Usefulness of 18F-fluorocholine positron emission tomography-computed tomography in locating lesions in hyperparathyroidism: a systematic review[J]. JAMA Otolaryngol Head Neck Surg, 2019, 145(8): 743−750. DOI: 10.1001/jamaoto.2019.0574. | |
[16] | Sacconi B, Argirò R, Diacinti D, et al. MR appearance of parathyroid adenomas at 3 T in patients with primary hyperparathyroidism: what radiologists need to know for pre-operative localization[J]. Eur Radiol, 2016, 26(3): 664−673. DOI: 10.1007/s00330-015-3854-5. | |
[17] | Mahajan A, Starker LF, Ghita M, et al. Parathyroid four-dimensional computed tomography: evaluation of radiation dose exposure during preoperative localization of parathyroid tumors in primary hyperparathyroidism[J]. World J Surg, 2012, 36(6): 1335−1339. DOI: 10.1007/s00268-011-1365-3. | |
[18] | Strauss SB, Roytman M, Phillips CD. Parathyroid imaging: four-dimensional computed tomography, sestamibi, and ultrasonography[J]. Neuroimaging Clin N Am, 2021, 31(3): 379−395. DOI: 10.1016/j.nic.2021.04.007. | |
[19] | Hofer T, Kronbichler J, Huber H, et al. 18F-Choline PET/CT, MRI, and software-based image fusion analysis in patients with primary hyperparathyroidism[J]. Clin Nucl Med, 2021, 46(9): 710−716. DOI: 10.1097/RLU.0000000000003738. | |
[20] | Huber GF, Hüllner M, Schmid C, et al. Benefit of 18F-fluorocholine PET imaging in parathyroid surgery[J]. Eur Radiol, 2018, 28(6): 2700−2707. DOI: 10.1007/s00330-017-5190-4. | |
[21] | Alharbi AA, Alshehri FM, Albatly AA, et al. [18F]Fluorocholine uptake of parathyroid adenoma is correlated with parathyroid hormone level[J]. Mol Imaging Biol, 2018, 20(5): 857−867. DOI: 10.1007/s11307-018-1179-x. | |
[22] | Grimaldi S, Young J, Kamenicky P, et al. Challenging pre-surgical localization of hyperfunctioning parathyroid glands in primary hyperparathyroidism: the added value of 18F-fluorocholine PET/CT[J]. Eur J Nucl Med Mol Imaging, 2018, 45(10): 1772−1780. DOI: 10.1007/s00259-018-4018-z. | |
[23] | Evangelista L, Ravelli I, Magnani F, et al. 18F-choline PET/CT and PET/MRI in primary and recurrent hyperparathyroidism: a systematic review of the literature[J]. Ann Nucl Med, 2020, 34(9): 601−619. DOI: 10.1007/s12149-020-01507-1. | |
[24] | Treglia G, Piccardo A, Imperiale A, et al. Diagnostic performance of choline PET for detection of hyperfunctioning parathyroid glands in hyperparathyroidism: a systematic review and meta-analysis[J]. Eur J Nucl Med Mol Imaging, 2019, 46(3): 751−765. DOI: 10.1007/s00259-018-4123-z. | |
[25] | Bioletto F, Barale M, Parasiliti-Caprino M, et al. Comparison of the diagnostic accuracy of 18F-fluorocholine PET and 11C-methionine PET for parathyroid localization in primary hyperparathyroidism: a systematic review and meta-analysis[J]. Eur J Endocrinol, 2021, 185(1): 109−120. DOI: 10.1530/EJE-21-0038. | |
[26] | Petranović Ovčariček P, Giovanella L, Carrió Gasset I, et al. The EANM practice guidelines for parathyroid imaging[J]. Eur J Nucl Med Mol Imaging, 2021, 48(9): 2801−2822. DOI: 10.1007/s00259-021-05334-y. | |
[27] | Hindié E, Zanotti-Fregonara P, Tabarin A, et al. The role of radionuclide imaging in the surgical management of primary hyperparathyroidism[J]. J Nucl Med, 2015, 56(5): 737−744. DOI: 10.2967/jnumed.115.156018. | |
[28] | Piccardo A, Trimboli P, Rutigliani M, et al. Additional value of integrated 18F-choline PET/4D contrast-enhanced CT in the localization of hyperfunctioning parathyroid glands and correlation with molecular profile[J]. Eur J Nucl Med Mol Imaging, 2019, 46(3): 766−775. DOI: 10.1007/s00259-018-4147-4. | |
[29] | Araz M, Soydal Ç, Özkan E, et al. The efficacy of fluorine-18-choline PET/CT in comparison with 99mTc-MIBI SPECT/CT in the localization of a hyperfunctioning parathyroid gland in primary hyperparathyroidism[J]. Nucl Med Commun, 2018, 39(11): 989−994. DOI: 10.1097/MNM.0000000000000899. | |
[30] | Kluijfhout WP, Vorselaars WMCM, van den Berk SAM, et al. Fluorine-18 fluorocholine PET-CT localizes hyperparathyroidism in patients with inconclusive conventional imaging: a multicenter study from the Netherlands[J]. Nucl Med Commun, 2016, 37(12): 1246−1252. DOI: 10.1097/MNM.0000000000000595. | |
[31] | Gatu A, Velicescu C, Grigorovici A, et al. The volume of solitary parathyroid adenoma is related to preoperative Pth and 25OH-D3, but not to calcium levels[J]. Acta Endocrinol (Buchar), 2017, 13(4): 441−446. DOI: 10.4183/aeb.2017.441. | |
[32] | Liberini V, Morand GB, Rupp NJ, et al. Histopathological features of parathyroid adenoma and 18F-choline uptake in PET/MR of primary hyperparathyroidism[J]. Clin Nucl Med, 2022, 47(2): 101−107. DOI: 10.1097/RLU.0000000000003987. | |
[33] | Ferrari C, Santo G, Mammucci P, et al. Diagnostic value of choline PET in the preoperative localization of hyperfunctioning parathyroid gland(s): a comprehensive overview[J]. Biomedicines, 2021, 9(3): 231. DOI: 10.3390/biomedicines9030231. | |
[34] | Zajíčková K, Zogala D, Kubinyi J. Parathyroid imaging by 18F-fluorocholine PET/CT in patients with primary hyperparathyroidism and inconclusive conventional methods: clinico-pathological correlations[J]. Physiol Res, 2018, 67(S3): S551−557. DOI: 10.33549/physiolres.934029. | |
[35] | Tomita T. Immunocytochemical staining patterns for parathyroid hormone and chromogranin in parathyroid hyperplasia, adenoma, and carcinoma[J]. Endocr Pathol, 1999, 10(2): 145−156. DOI: 10.1007/BF02739826. | |
[36] | Kluijfhout WP, Pasternak JD, Gosnell JE, et al. 18F fluorocholine PET/MR imaging in patients with primary hyperparathyroidism and inconclusive conventional imaging: a prospective pilot study[J]. Radiology, 2017, 284(2): 460−467. DOI: 10.1148/radiol.2016160768. |