В обзоре представлены данные о современных подходах к диагностике различных проявлений гиперпаратиреоза по данным мультиспиральной компьютерной томографии, которые не требуют морфологической верификации и обеспечивают корректность диагностического процесса. Подробно описаны лучевая картина и дифференциальная диагностика изменений со стороны паращитовидных желез и костных структур при гиперпаратиреозе.
The article presents data on modern approaches to the diagnosis of various manifestations of hyperparathyroidism according to multispiral computed tomography, which do not require morphological verification and ensure the correctness of the diagnostic process. The radiological picture and differential diagnostics of changes from parathyroid glands and bone structures at hyperparathyroidism are described in detail.
Keywords: computed tomography, adenoma of parathyroid gland, hyperplasia of the parathyroid gland, cancer of the parathyroid gland.
Список литературы
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________________________________________________
1. [Dedov II, Melnichenko GA, Mokrysheva NG, Rozhinskaya LYa, Kusnezov NS, Pigarova EA, Voronkova IA, Lipatenkova AK, Egshatyan LV, Mamedova EO, Krupinova YuA. Primary hyperparathyroidism: the clinical picture, diagnostics, differential diagnostics, and methods of treatment. Problemy Endocrinologii. 2016;62(6):40-77 (In Russ.)]. doi: 10.14341/probl201662640-77
2. [Kalinin AP. Khirurgicheskaya endokrinologiya [Surgical endocrinology]. St. Petersburg: Piter; 2004. 960 p. (In Russ.)].
3. [Romanchishen AF. Khirurgiya shchitovidnoi i okoloshchitovidnykh zhelez [Surgery of the thyroid and parathyroid glands]. St. Petersburg: Vesti; 2009. 648 p. (In Russ.)].
4. [Golokhvastov NN. Giperkal'tsiemiya. Pervichnyi giperparatireoz [Hypercalcemia. Primary hyperparathyroidism]. St. Petersburg: Gippokrat; 2003. 136 p. (In Russ.)].
5. Rodgers SE, Hunter GJ, Hamberg LM, Schellingerhout D,
Doherty DB, Ayers GD, et al. Improved preoperative planning for directed parathyroidectomy with 4-dimensional computed tomography. Surgery. 2006;140(6):932-41. doi: 10.1016/j.surg.2006.07.028
6. Seeliger B, Alesina PF, Koch JA, Hinrichs J, Meier B, Walz MK. Diagnostic value and clinical impact of complementary CT scan prior to surgery for non-localized primary hyperparathyroidism. Langenbeck’s Arch Surg. 2015;400(3):307-12. doi: 10.1007/s00423-015-1282-2
7. Hunter GJ, Schellingerhout D, Vu TH, Perrier ND, Hamberg LM. Accuracy of four-dimensional CT for the localization of abnormal parathyroid glands in patients with primary hyperparathyroidism. Radiology. 2012;264(3):789-95. doi: 10.1148/radiol.12110852
8. Mortenson MM, Evans DB, Lee JE, Hunter GJ, Shellingerhout D, Vu T, Edeiken BS, Feng L, Perrier ND. Parathyroid exploration in the reoperative neck: improved preoperative localization with 4D-computed tomography. J Am Coll Surg. 2008;206(5):888-95, discussion 895-886. doi: 10.1016/j.jamcollsurg.2007.12.044
9. Fitzgerald RT. CT Imaging for Parathyroid Disease. In: Medical and Surgical Treatment of Parathyroid Diseases. Springer International Publishing; 2017. P. 151-9.
10. Hoang JK, Sung WK, Bahl M, Phillips CD. How to perform parathyroid 4D CT: tips and traps for technique and interpretation. Radiology. 2014;270(1):15-24. doi: 10.1148/radiol.13122661
11. Weber AL, Randolph G, Aksoy FG. The thyroid and parathyroid glands: CT and MR imaging and correlation with pathology and clinical findings. Radiol Clin N Am. 2000;38(5):1105-29. doi: 10.1007/ s11604-006-0068-4
12. Carlson D. Parathyroid pathology: hyperparathyroidism and parathyroid tumors. Arch Pathol Lab Med. 2010;134(11):1639-44.
doi: 10.1043/2009-0578-CCR.1
13. Ruda JM, Hollenbeak CS, Stack BC Jr. A systematic review of the diagnosis and treatment of primary hyperparathyroidism from 1995
to 2003. Otolaryngol Head Neck Surg. 2005;132(3):359-72.
doi: 10.1016/j.otohns.2004.10.005
14. Randall GJ, Zald PB, Cohen JI, Hamilton BE. Contrast-enhanced
MDCT characteristics of parathyroid adenomas. AJR Am J Roentgenol. 2009;193(2):139-43. doi: 10.2214/AJR.08.2098
15. Lumachi F, Zucchetta P, Varotto S, Polistina F, Favia G, D’Amico D. Noninvasive localization procedures in ectopic hyperfunctioning parathyroid tumors. Endocr Relat Cancer. 1999;6(1):123-5.
doi: 10.1677/erc.0.0060123
16. Udelsman R, Donovan PI. Remedial parathyroid surgery: changing trends in 130 consecutive cases. Ann Surg. 2006;244(3):471-9.
doi: 10.1097/01.sla.0000234899.93328.30
17. Perrier ND, Edeiken B, Nunez R, Gayed I, Jimenez C, Busaidy N, Vu T. A novel nomenclature to classify parathyroid adenomas. World J Surg. 2009;33(3):412-6. doi: 10.1007/s00268-008-9894-0
18. Gafton AR, Glastonbury CM, Eastwood JD, Hoang JK. Parathyroid lesions: characterization with dual-phase arterial and venous enhanced CT of the neck. AJNR Am J Neuroradiol. 2012;33(5):949-52.
doi: 10.3174/ajnr.A2885
19. Sackett WR, Reeve TS, Barraclough B, Delbridge L. Thyrothymic thyroid rests: incidence and relationship to the thyroid gland. J Am Coll Surg. 2002;195(5):635-40. doi: 10.1016 / S1072-7515 (02) 01319-4
20. Bahl M, Muzaffar M, Vij G, Sosa JA, Choudhury KR, Hoang JK. Prevalence of the polar vessel sign in parathyroid adenomas on the arterial phase of 4D CT. AJNR Am J Neuroradiol. 2013;35(3):578-81. doi: 10.3174/ajnr.A3715
21. Shantz A, Castleman B. Parathyroid carcinoma: a study of 70 cases. Cancer. 1973;31(3):600-5. doi: 10.1002/1097-0142(197303)31:3<600:: AID-CNCR2820310316>3.0.CO;2-0
22. Sturniolo G, Gagliano E, Tonante A, Taranto F, Papalia E, Cascio R, Damiano C, Vermiglio F, Sturniolo G. Parathyroid carcinoma: case report. G Chir. 2013;34(5-6):170-2. doi: 10.11138/gchir/2013.34.5.170
23. Poeppel TD, Krause BJ, Heusner TA. PET/CT for the staging and follow-up of patients with malignancies. Eur J Radiol. 2009;70(3):382-92. doi: 10.1016/j.ejrad.2009.03.051
24. [Mazurenko SO, Shishkin AN, Yen'kin AA, et al. Results of long-term study of bone mineral density in patients with end stage of Chronic kidney disease. Vestnik Sankt-Peterburgskogo Universiteta. 2006;11(4):17-33. (In Russ.)].
25. Khan A, Bilezikian J. Primary hyperparathyroidism: pathophysiology and impact on bone. CMAJ. 2000;163(2):184-7.
26. Hamrahian M, Pitman KT, Csongrádi É, Bain JH, Kanyicska B, Fülöp T. Symmetrical craniofacial hypertrophy in patients with tertiary hyperparathyroidism and high-dose cinacalcet exposure. Hemodialysis Intern. 2012;16(4):571-6. doi: 0.1111/j.1542-4758.2012.00670.x
27. Pechalova PF, Poriazova EG. Brown tumor at the jaw in patients with secondary hyperparathyroidism due to chronic renal failure. Acta Med. 2013;56(2):83-6. doi: 10.14712/18059694.2014.29
28. [Dedov II, Mel'nichenko GA, editors. Endokrinologiya. Natsional'noe rukovodstvo [Endocrinology. National Guidelines]. Moscow: GEOTAR-Media; 2009. P. 769-76. (In Russ.)].
29. Orejas G, Rey C, Vicente SG, et al. Maxillary brown tumor as manifestation of renal osteodystrophy. Nephron. 1993;64:483-4. doi: 10.1159/ 000187380
30. Fineman I, Johnson JP, Di-Patre PL, Sandhu H. Chronic renal failure causing brown tumors and myelopathy: Case report and review of pathophysiology and treatment. J Neurosurg. 1999;90(4):242-6.
doi: 0.3171/spi.1999.90.2.0242
31. Selvi F, Cakarer S, Tanakol R, Guler SD, Keskin C. Brown tumour of the maxilla and mandible: a rare complication of tertiary hyperparathyroidism. Dentomaxillofacial Radiology. 2009;38(1):53-8.
doi: 10.1259/dmfr/81694583
32. Takeshita T, Takeshita K, Abe S, Takami H, Imamura T, Furui S. Brown tumor with fluid-fluid levels in a patient with primary hyperparathyroidism: radiological findings. Radiat Med. 2006;24(9):631-4. doi: 10.1007/s11604-006-0068-4
33. [Blagosklonnaya Ya, Shlyakhto Ye, Babenko A. Endokrinologiya. Uchebnik dlya meditsinskikh vuzov [Endocrinology. Textbook for medical universities] 3rd ed. St. Petersburg: SpetsLit; 2012. P. 197-9 (In Russ.)].
34. Merz MN, Massich DD, Marsh W, Schuller DE. Hyperparathyroidism presenting as brown tumor of the maxilla. Am J Otolaryngol. 2002;23(3):173-6. doi: 10.1053/ajot.2002.123435
35. [Reiser M, Baur-Melnik A, Glaser K. Luchevaya diagnostika. Kostno-myshechnaya sistema [Direct diagnosis in Radiology. Musculoskeletal imaging]. Moscow: MEDpress-inform; 2011. P. 40-3 (In Russ.)].
36. Niemann T, Kollmann T, Bongartz G. Diagnostic performance of low-dose CT for the detection of urolithiasis: a meta-analysis. Am J Roentgenol. 2008;191(2):396-401. doi: 10.2214/AJR.07.3414
37. Stabile IA, Wolowiec A, Francioso G, Scardapane A, Rotondo A, Angelelli G. Benign and malignant gastric ulcer: CT findings. La Radiologia medica. 2000;102(1-2):32-6.
1 ФГБУ«Эндокринологический научный центр» Минздрава России, Москва, Россия;
2 ФГБУ «Институт хирургии им. А.В. Вишневского» Минздрава России, Москва, Россия
1 Russian Federal State Endocrinology Research Centre, Ministry of Health of Russia, Moscow, Russia;
2 A.v. Vishnevsky Institute of Surgery, Ministry of Health of Russia, Moscow, Russia