维持性血透继发甲旁亢时骨关节的影像学改变

摘要

Objective:To investigate the X-ray and CT findings of bone and joint and their values in the maintenance hemodialysis ( MHD) patients with hyperparathyroidism .Methods:42 MHD patients with hyperparathyroidism underwent X-ray and CT examination, and the detected sites included the skull , shoulder, wrist, hands, hip, knee, ankle and lumbar.The imaging changes were observed .Results:Of 42 patients, X-ray showed osteoporosis in 38 cases, bone destruction in 12 cases, bone resorption in 17 cases, bone sclerosis in 10 cases, joint swelling in 18 cases, metastatic soft tissue calcification in 18 cases;CT examination showed osteoporosis in 42 cases, bone destruction in 14 cases, bone resorption in 19 cases, bone sclerosis in 10 cases, joint swelling in 20 cases, metastatic calcification within the soft tissue in 18 cases, joint capsule effusion in 10 cases. Conclusion: X-ray examination is the first choice for the observation of bone and joint lesions in MHD patients with hyperparathyroidism.CT is an important supplement for early diagnosis and differential diagnosis .%目的：探讨维持性血液透析患者合并甲状旁腺功能亢进的骨和关节X线平片及CT表现及其临床价值。方法：收集我院稳定性维持血液透析且合并甲状旁腺功能亢进患者42例，行X线平片及CT检查，部位包括颅骨、肩关节、腕关节、双手、髋关节、膝关节、踝关节、腰椎，观察其影像学改变。结果：42例患者X线平片显示骨质疏松38例，骨质破坏12例，骨质吸收17例，骨质硬化10例，关节肿胀18例，软组织内转移性钙化18例；CT检查显示骨质疏松42例，骨质破坏14例，骨质吸收19例，骨质硬化10例，关节肿胀20例，软组织内转移性钙化18例，关节囊积液10例。结论：X线平片检查是观察维持性血液透析患者合并甲状旁腺功能亢进的骨、关节病变的首选方法， CT是发现早期病变及鉴别诊断的重要补充检查方法。